{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T18:19:43Z","timestamp":1787941183608,"version":"build-2784847793"},"reference-count":37,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Myeloma Patients Europe"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple myeloma (MM) is characterized by complex and evolving treatment pathways, involving multiple preference-sensitive decisions across the disease trajectory. Shared decision-making (SDM) is widely recognized as a best-practice approach for such decisions, yet practical, context-specific guidance for implementing SDM in MM care remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop a set of practical, stakeholder-informed recommendations to support the implementation of SDM in MM care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted as part of a European mixed-methods research project initiated by the patient organization Myeloma Patients Europe. Building on empirical studies involving MM patients and healthcare professionals (HCPs), an initial set of 24 recommendations was developed. These recommendations were subsequently refined, and agreed upon through two online multi-stakeholder workshops, involving patients, carers, hematologists, oncology nurses, and patient organization representatives from multiple European countries. Qualitative workshop data were thematically analyzed, and recommendations were consolidated through iterative team discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final output comprises ten core recommendations addressing SDM implementation at multiple levels. Key themes included in the recommendations are adopting a personalized and preference-sensitive approach to patient involvement, tailoring information provision, openly discussing all treatment options including no treatment, strengthening multidisciplinary communication, supporting patient preparation and partnership, ensuring continuity of care, and providing structural, educational, and organizational support for SDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These recommendations translate SDM principles into guiding considerations tailored to the specific challenges of MM care. They provide a foundation for context-sensitive implementation efforts aimed at strengthening patient-centered decision-making in MM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0355283","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:53:55Z","timestamp":1787939635000},"page":"e0355283","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Practical recommendations for the implementation of shared decision-making in multiple myeloma care"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3663-0334","authenticated-orcid":true,"given":"Jolien","family":"Broekmans","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elise","family":"Schoefs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7149-2239","authenticated-orcid":true,"given":"Charlotte","family":"Verbeke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lien","family":"De Proost","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sil\u00e8ne","family":"ten Seldam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eilidh","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Aviv","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varda","family":"Shoham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Delforge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneleen","family":"Vanhellemont","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Huys","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"pone.0355283.ref001","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1056\/NEJMra1011442","article-title":"Multiple Myeloma","volume":"364","author":"A Palumbo","year":"2011","journal-title":"New England J Med"},{"issue":"22","key":"pone.0355283.ref002","doi-asserted-by":"crossref","first-page":"8040","DOI":"10.1002\/cam4.4322","article-title":"Trust and shared decision-making among individuals with multiple myeloma: A qualitative study","volume":"10","author":"RL Whitney","year":"2021","journal-title":"Cancer Med"},{"key":"pone.0355283.ref003","doi-asserted-by":"crossref","first-page":"17046","DOI":"10.1038\/nrdp.2017.46","article-title":"Multiple myeloma","volume":"3","author":"SK Kumar","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0355283.ref004","doi-asserted-by":"crossref","first-page":"686165","DOI":"10.3389\/fmed.2021.686165","article-title":"Patient preferences for multiple myeloma treatments: a multinational qualitative study","volume":"8","author":"R Janssens","year":"2021","journal-title":"Front Med (Lausanne)"},{"issue":"2","key":"pone.0355283.ref005","doi-asserted-by":"crossref","first-page":"232","DOI":"10.3324\/haematol.2013.099358","article-title":"European Myeloma Network recommendations on the evaluation and treatment of newly diagnosed patients with multiple myeloma","volume":"99","author":"M Engelhardt","year":"2014","journal-title":"Haematologica"},{"issue":"9","key":"pone.0355283.ref006","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1016\/j.pec.2019.04.028","article-title":"Review of the patient-centered communication landscape in multiple myeloma and other hematologic malignancies","volume":"102","author":"TW LeBlanc","year":"2019","journal-title":"Patient Educ Couns"},{"issue":"2","key":"pone.0355283.ref007","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1111\/bjh.14213","article-title":"Multiple myeloma: patient outcomes in real-world practice","volume":"175","author":"K Yong","year":"2016","journal-title":"Br J Haematol"},{"issue":"10","key":"pone.0355283.ref008","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s11606-012-2077-6","article-title":"Shared decision making: a model for clinical practice","volume":"27","author":"G Elwyn","year":"2012","journal-title":"J Gen Intern Med"},{"key":"pone.0355283.ref009","article-title":"A three-talk model for shared decision making: multistage consultation process","volume":"359","author":"G Elwyn","year":"2017","journal-title":"BMJ"},{"issue":"11","key":"pone.0355283.ref010","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/S0959-8049(99)00212-9","article-title":"Effective communication skills are the key to good cancer care","volume":"35","author":"L Fallowfield","year":"1999","journal-title":"Eur J Cancer"},{"issue":"3","key":"pone.0355283.ref011","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1016\/j.pec.2008.07.018","article-title":"Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals\u2019 perceptions","volume":"73","author":"F L\u00e9gar\u00e9","year":"2008","journal-title":"Patient Educ Couns"},{"issue":"6","key":"pone.0355283.ref012","first-page":"377","article-title":"Implementing and evaluating shared decision making in oncology practice","volume":"64","author":"HL Kane","year":"2014","journal-title":"CA Cancer J Clin"},{"issue":"8","key":"pone.0355283.ref013","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1200\/JCO.2011.37.7952","article-title":"Meeting the decision-making preferences of patients with breast cancer in oncology consultations: impact on decision-related outcomes","volume":"30","author":"R Brown","year":"2012","journal-title":"J Clin Oncol"},{"issue":"4","key":"pone.0355283.ref014","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.ejon.2008.03.004","article-title":"Preferences for involvement in treatment decision making of patients with cancer: a review of the literature","volume":"12","author":"G Hubbard","year":"2008","journal-title":"Eur J Oncol Nurs"},{"issue":"3","key":"pone.0355283.ref015","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.pec.2013.10.031","article-title":"Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making","volume":"94","author":"N Joseph-Williams","year":"2014","journal-title":"Patient Educ Couns"},{"issue":"1","key":"pone.0355283.ref016","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1186\/s12911-025-03229-8","article-title":"Patients and healthcare professionals\u2019 perspectives on the implementation of shared decision making in multiple myeloma: a multinational qualitative study","volume":"25","author":"E Schoefs","year":"2025","journal-title":"BMC Med Inform Decis Mak"},{"key":"pone.0355283.ref017","article-title":"Enhancing patient involvement through shared decision-making: are we there yet in multiple myeloma?","author":"C Verbeke","year":"2026","journal-title":"PLoS One"},{"key":"pone.0355283.ref018","unstructured":"Home - Myeloma Patients Europe. https:\/\/www.mpeurope.org\/. Accessed 2026 April 3."},{"issue":"3","key":"pone.0355283.ref019","first-page":"655","article-title":"How to use the nominal group and Delphi techniques","volume":"38","author":"SS McMillan","year":"2016","journal-title":"Int J Clin Pharm"},{"key":"pone.0355283.ref020","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"NK Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"pone.0355283.ref021","unstructured":"Macmillan Cancer Support. Holistic Needs Assessment (HNA). https:\/\/www.macmillan.org.uk\/healthcare-professionals\/innovation-in-cancer-care\/holistic-needs-assessment. Accessed 2026 April 29."},{"issue":"2","key":"pone.0355283.ref022","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/s41408-021-00432-4","article-title":"Management of patients with multiple myeloma beyond the clinical-trial setting: understanding the balance between efficacy, safety and tolerability, and quality of life","volume":"11","author":"E Terpos","year":"2021","journal-title":"Blood Cancer J"},{"key":"pone.0355283.ref023","article-title":"Advances in the treatment of newly diagnosed multiple myeloma: current status and future directions","author":"Y Liu","year":"2026","journal-title":"healthbook TIMES Oncology Hematology"},{"issue":"1","key":"pone.0355283.ref024","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3109\/13561820.2010.490502","article-title":"Interprofessionalism and shared decision-making in primary care: a stepwise approach towards a new model","volume":"25","author":"F L\u00e9gar\u00e9","year":"2011","journal-title":"J Interprof Care"},{"issue":"8","key":"pone.0355283.ref025","doi-asserted-by":"crossref","DOI":"10.2196\/18223","article-title":"Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions","volume":"4","author":"Y Zisman-Ilani","year":"2020","journal-title":"JMIR Form Res"},{"issue":"10","key":"pone.0355283.ref026","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1007\/s00192-025-06147-5","article-title":"Shared decision-making (SDM) for female SUI: current practice in three western countries","volume":"36","author":"NJE Osse","year":"2025","journal-title":"Int Urogynecol J"},{"key":"pone.0355283.ref027","doi-asserted-by":"crossref","first-page":"1162993","DOI":"10.3389\/fpubh.2023.1162993","article-title":"Shared decision-making in healthcare in mainland China: a scoping review","volume":"11","author":"X Li","year":"2023","journal-title":"Front Public Health"},{"issue":"6","key":"pone.0355283.ref028","doi-asserted-by":"crossref","first-page":"468","DOI":"10.7861\/clinmed.2019-0292","article-title":"Pathway redesign: putting patients ahead of professionals","volume":"19","author":"MP Grocott","year":"2019","journal-title":"Clin Med (Lond)"},{"issue":"1","key":"pone.0355283.ref029","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/s12877-018-0853-9","article-title":"Supporting shared decision making for older people with multiple health and social care needs: a realist synthesis","volume":"18","author":"F Bunn","year":"2018","journal-title":"BMC Geriatr"},{"issue":"3","key":"pone.0355283.ref030","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1007\/s13187-012-0371-y","article-title":"Feasibility of training oncology residents in shared decision making: a pilot study","volume":"27","author":"D Stacey","year":"2012","journal-title":"J Cancer Educ"},{"key":"pone.0355283.ref031","article-title":"Organizational- and system-level characteristics that influence implementation of shared decision-making and strategies to address them - a scoping review","author":"I Scholl","year":"2018","journal-title":"Implement Sci"},{"issue":"2","key":"pone.0355283.ref032","doi-asserted-by":"crossref","first-page":"2381468320963070","DOI":"10.1177\/2381468320963070","article-title":"Enhancing success of medicare\u2019s shared decision making mandates using implementation science: examples applying the pragmatic robust implementation and sustainability model (PRISM)","volume":"5","author":"DD Matlock","year":"2020","journal-title":"MDM Policy Pract"},{"issue":"2","key":"pone.0355283.ref033","doi-asserted-by":"crossref","first-page":"8","DOI":"10.5334\/ijic.6554","article-title":"Healthcare Professionals\u2019 Perceptions about the Implementation of Shared Decision-Making in Primary Care: A Qualitative Study from a Virtual Community of Practice","volume":"24","author":"A Torres-Casta\u00f1o","year":"2024","journal-title":"Int J Integr Care"},{"issue":"5","key":"pone.0355283.ref034","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1188\/15.CJON.548-556","article-title":"The evolving role of the nurse during the cancer treatment decision-making process: a literature review","volume":"19","author":"JD Tariman","year":"2015","journal-title":"Clin J Oncol Nurs"},{"issue":"1","key":"pone.0355283.ref035","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1186\/s12913-023-09778-w","article-title":"Major influencing factors on routine implementation of shared decision-making in cancer care: qualitative process evaluation of a stepped-wedge cluster randomized trial","volume":"23","author":"P Hahlweg","year":"2023","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0355283.ref036","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1186\/s12911-023-02263-8","article-title":"Implementing shared decision-making interventions in breast cancer clinical practice: a scoping review","volume":"23","author":"N Oprea","year":"2023","journal-title":"BMC Med Inform Decis Mak"},{"issue":"1","key":"pone.0355283.ref037","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1186\/s13012-019-0951-x","article-title":"Action, actor, context, target, time (AACTT): a framework for specifying behaviour","volume":"14","author":"J Presseau","year":"2019","journal-title":"Implement Sci"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0355283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:53:59Z","timestamp":1787939639000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0355283"}},"subtitle":[],"editor":[{"given":"Mehmet","family":"Baysal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,28]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0355283","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]}}}