{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T15:03:59Z","timestamp":1790003039244,"version":"4.0.1"},"reference-count":29,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009032","name":"Pfizer UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009032","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,7,30]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"\n Background<\/jats:title>\n Multiple myeloma (MM) is a chronic haematological malignancy caused by the proliferation of malignant plasma cells in the bone marrow and overproduction of monoclonal antibodies. While no cure is available, treatments aim to control the disease and place patients into remission.<\/jats:p>\n <\/jats:sec>\n \n Aims and objectives<\/jats:title>\n This research aimed to explore the psychological impact and healthcare experiences of patients affected by triple-class refractory (TCR) MM. This research formed part of a wider qualitative study examining the experiences of newly diagnosed, double-class exposed and TCRMM patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This qualitative, semi-structured interview study using Interpretative Phenomenological Analysis examined patient experiences. Patients were recruited through Myeloma UK, a charity for patients with MM and carers.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seven patients diagnosed with TCRMM (five men and two women), aged 41\u201384 years (\n M<\/jats:italic>\n =60 years, 3 months, SD=15 years) provided written consent. Two patients had become TCRMM within 6\u201312 months of MM diagnosis, one patient within 1\u20135 years and four patients over 5 years. Three overarching themes were identified that captured the key unmet needs of those affected by TCRMM: (1)\n Matching psychological support to specific moments<\/jats:italic>\n identified drivers for regular psychological input at key points in the patient pathway; (2)\n Finding a voice in treatment decisions<\/jats:italic>\n reflected patients\u2019 perceived lack of involvement in treatment decisions and their desire to be more engaged; and (3)\n Learning to navigate clinical trials<\/jats:italic>\n highlighted the challenges associated with accessing transparent information about trials and the complexities of eligibility criteria.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The results demonstrate the psychological burden of TCRMM and the associated treatments across patient management and\/or care. Likewise, patient access to informative materials and practical tools to support engagement in informed decision-making, specifically around treatments and clinical trials, needs to be more routinely offered and made available.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-108269","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:25:48Z","timestamp":1790000748000},"page":"e108269","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the psychological impact and healthcare experiences of patients living with\n triple class refractory multiple myeloma:<\/b>\n an interpretative phenomenological analysis study"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1913-8186","authenticated-orcid":false,"given":"Noreen","family":"Ali","sequence":"first","affiliation":[{"name":"Pfizer UK, Tadworth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3632-8740","authenticated-orcid":false,"given":"Luke","family":"Kuttschreuter","sequence":"additional","affiliation":[{"name":"R&D, Pfizer UK, Sandwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Quinn","sequence":"additional","affiliation":[{"name":"Myeloma UK, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Wood","sequence":"additional","affiliation":[{"name":"Pfizer UK, Tadworth, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Harris","sequence":"additional","affiliation":[{"name":"Customer Faithful, Peterborough, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"2026092107251058000_16.9.e108269.1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26590"},{"key":"2026092107251058000_16.9.e108269.2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.leukres.2017.05.019","article-title":"Living with the burden of relapse in multiple myeloma from the patient and physician perspective","volume":"59","author":"Hulin","year":"2017","journal-title":"Leuk Res"},{"key":"2026092107251058000_16.9.e108269.3","doi-asserted-by":"crossref","first-page":"1178224219868235","DOI":"10.1177\/1178224219868235","article-title":"Multiple myeloma: an overview of management","volume":"13","author":"Bird","year":"2019","journal-title":"Palliat Care Soc Pract"},{"key":"2026092107251058000_16.9.e108269.4","unstructured":"Myeloma UK . Behind the headlines: how many people are living with myeloma. 2025. Available: https:\/\/www.myeloma.org.uk\/news\/behind-the-headlines-how-many-people-are-living-with-myeloma\/ [Accessed 16 Nov 2025]."},{"key":"2026092107251058000_16.9.e108269.5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/ejh.12882","article-title":"A systematic review of health-related quality of life in longitudinal studies of myeloma patients","volume":"99","author":"Nielsen","year":"2017","journal-title":"Eur J Haematol"},{"key":"2026092107251058000_16.9.e108269.6","doi-asserted-by":"crossref","first-page":"e52","DOI":"10.1111\/bjh.17946","article-title":"The future of myeloma research in Canada and beyond: results of a James Lind Alliance priority setting partnership","volume":"196","author":"Fowler","year":"2022","journal-title":"Br J Haematol"},{"key":"2026092107251058000_16.9.e108269.7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2010.01542.x"},{"key":"2026092107251058000_16.9.e108269.8","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.3390\/curroncol30020179","article-title":"Relapsed\/Refractory Multiple Myeloma: A Review of Available Therapies and Clinical Scenarios Encountered in Myeloma Relapse","volume":"30","author":"Bhatt","year":"2023","journal-title":"Curr Oncol"},{"key":"2026092107251058000_16.9.e108269.9","doi-asserted-by":"crossref","first-page":"2554","DOI":"10.1038\/s41375-024-02404-6","article-title":"LocoMMotion: a study of real-life current standards of care in triple-class exposed patients with relapsed\/refractory multiple myeloma - 2-year follow-up (final analysis)","volume":"38","author":"Mateos","year":"2024","journal-title":"Leukemia"},{"key":"2026092107251058000_16.9.e108269.10","first-page":"2435","article-title":"\u201cIt is a journey of discovery\u201d: living with myeloma","volume":"27","author":"de Wet","year":"2019","journal-title":"Support Care Cancer"},{"key":"2026092107251058000_16.9.e108269.11","doi-asserted-by":"crossref","DOI":"10.1182\/blood-2021-145096","article-title":"Patient, Caregiver, and Healthcare Provider Priorities for Future Multiple Myeloma Research: Results of a James Lind Alliance Priority Setting Partnership","volume":"138","author":"Reiman","year":"2021","journal-title":"Blood"},{"key":"2026092107251058000_16.9.e108269.12","doi-asserted-by":"crossref","DOI":"10.1182\/blood-2024-209905","article-title":"A National UK Survey of Multiple Myeloma Patient Led Research Priorities: Embedding PROMs, Patient Characteristics and Patient Perspectives","volume":"144","author":"Quinn","year":"2024","journal-title":"Blood"},{"key":"2026092107251058000_16.9.e108269.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-019-5467-x","article-title":"Treatment preferences of patients with relapsed and refractory multiple myeloma: a qualitative study","volume":"19","author":"Parsons","year":"2019","journal-title":"BMC Cancer"},{"key":"2026092107251058000_16.9.e108269.14","doi-asserted-by":"crossref","unstructured":"Smith JA , Flowers P , Larkin M . 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