{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:08:44Z","timestamp":1782846524962,"version":"3.54.5"},"reference-count":41,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Res Protoc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple myeloma (MM) is associated with the greatest symptom burden of all hematological cancers and, despite substantial improvements in treatment options with high response and survival rates, is still considered incurable, with patients undergoing multiple lines of therapy over many years. Subcutaneous (SC) injections are a common mode of delivery for current and future MM therapy, with evidence suggesting that programs that give patients or carers responsibility for administration can bring benefits to the patient and health care system by reducing the number of required visits to hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study will explore and describe barriers to and enablers of implementing nurse-enabled SC therapy self-administration programs for patients with MM to develop a road map for national scalability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This qualitative descriptive study is informed by the Consolidated Framework for Implementation Research. Participants included key stakeholders from across Australia, including patients, carers, health professionals, and policymakers with experience of implementation, facilitation, and participation in nurse-enabled SC therapy self-administration programs. Data were collected via virtual focus groups or semistructured interviews and analyzed using the framework method to identify barriers and enablers. The Expert Recommendations for Implementing Change matching tool will be used to develop strategies to target barriers and enhance enablers, informing the development of a national road map.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study was funded in March 2024 and approved by Peter MacCallum Cancer Centre Human Research Ethics Committee in May 2024. Data collection was conducted between June 2024 and November 2024. A total of 32 participants were recruited. Data analysis is underway, with results expected to be published in February 2026.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>To our knowledge, this study will be the first of its kind to identify and compare barriers to and enablers of implementing nurse-enabled SC self-administration programs for patients with MM. Applying the Consolidated Framework for Implementation Research to guide study processes provides an evidence-informed approach to understanding how discrete and intersecting factors influence program implementation and sustainability, informing the development of a comprehensive implementation road map. As the availability of SC therapies grows for other cancers and chronic diseases, this model of care could serve as a blueprint for broader applications, impacting patient quality of life and optimization of health care use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/85053","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T09:40:10Z","timestamp":1764668410000},"page":"e85053-e85053","source":"Crossref","is-referenced-by-count":0,"title":["Establishing Barriers to and Enablers of Nurse-Enabled Subcutaneous Therapy Self-Administration Programs for Patients With Myeloma: Protocol for a Qualitative Descriptive Study"],"prefix":"10.2196","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5144-503X","authenticated-orcid":false,"given":"Hayley","family":"Beer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1408-3615","authenticated-orcid":false,"given":"Lisa","family":"Guccione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9210-5373","authenticated-orcid":false,"given":"Amit","family":"Khot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4555-6582","authenticated-orcid":false,"given":"Simon","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3050-4213","authenticated-orcid":false,"given":"Meinir","family":"Krishnasamy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21590","article-title":"Cancer statistics, 2020","volume":"70","author":"Siegel","journal-title":"CA Cancer J Clin"},{"key":"R2","unstructured":"Multiple myeloma in Australia statistics. Cancer Australia. URL: https:\/\/www.canceraustralia.gov.au\/cancer-types\/myeloma\/multiple-myeloma-australia-statistics [Accessed 11-12-2025]"},{"issue":"1","key":"R3","doi-asserted-by":"publisher","first-page":"570","DOI":"10.1186\/s12885-019-5649-6","article-title":"Coverage of cancer services in Australia and providers\u2019 views on service gaps: findings from a national cross-sectional survey","volume":"19","author":"Hunter","journal-title":"BMC Cancer"},{"issue":"5","key":"R4","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1111\/ejh.12790","article-title":"Prevalence of symptoms in patients with multiple myeloma: a systematic review and meta-analysis","volume":"97","author":"Ramsenthaler","journal-title":"Eur J Haematol"},{"issue":"6","key":"R5","doi-asserted-by":"publisher","first-page":"151338","DOI":"10.1016\/j.soncn.2022.151338","article-title":"Providing care to people living with a chronic hematological malignancy: a qualitative evidence synthesis of informal carers\u2019 experiences","volume":"38","author":"Cormican","journal-title":"Semin Oncol Nurs"},{"issue":"3","key":"R6","doi-asserted-by":"publisher","first-page":"e174","DOI":"10.1097\/NCC.0000000000001292","article-title":"An integrative review of the support needs of informal caregivers of hematological cancer patients in the period immediately following discharge from inpatient to outpatient care","volume":"48","author":"Brunt","journal-title":"Cancer Nurs"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2022.103728","article-title":"Unmet supportive care needs of people with advanced cancer and their caregivers: a systematic scoping review","volume":"176","author":"Hart","journal-title":"Crit Rev Oncol Hematol"},{"issue":"1","key":"R8","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s12904-018-0346-9","article-title":"Unmet care needs of advanced cancer patients and their informal caregivers: a systematic review","volume":"17","author":"Wang","journal-title":"BMC Palliat Care"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2021.104162","article-title":"Effectiveness of psychoeducational interventions among caregivers of patients with cancer: a systematic review and meta-analysis","volume":"127","author":"Cheng","journal-title":"Int J Nurs Stud"},{"issue":"5","key":"R10","doi-asserted-by":"publisher","first-page":"3793","DOI":"10.1007\/s00520-021-06713-9","article-title":"Mapping a decade of interventions to address the supportive care needs of individuals living with or beyond cancer: a scoping review of reviews","volume":"30","author":"Edney","journal-title":"Support Care Cancer"},{"issue":"16","key":"R11","doi-asserted-by":"publisher","first-page":"3051","DOI":"10.1200\/JCO.22.01799","article-title":"Financial toxicity in cancer care: implications for clinical care and potential practice solutions","volume":"41","author":"Khan","journal-title":"J Clin Oncol"},{"issue":"1","key":"R12","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1111\/imj.12640","article-title":"Treatment of patients with multiple myeloma who are eligible for stem cell transplantation: position statement of the Myeloma Foundation of Australia Medical and Scientific Advisory Group","volume":"45","author":"Quach","journal-title":"Intern Med J"},{"issue":"12","key":"R13","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1080\/17474086.2021.2022471","article-title":"The development of a home-based therapeutic platform for multiple myeloma","volume":"14","author":"Beer","journal-title":"Expert Rev Hematol"},{"key":"R14","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2019.04.025","article-title":"Implementation science: what is it and why should I care?","volume":"283","author":"Bauer","journal-title":"Psychiatry Res"},{"issue":"6","key":"R15","doi-asserted-by":"publisher","first-page":"1819","DOI":"10.3390\/cancers15061819","article-title":"Bispecific antibodies in multiple myeloma: opportunities to enhance efficacy and improve safety","volume":"15","author":"Swan","journal-title":"Cancers (Basel)"},{"issue":"1","key":"R16","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13012-021-01181-5","article-title":"Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum","volume":"17","author":"Damschroder","journal-title":"Implement Sci"},{"key":"R17","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50","article-title":"Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science","volume":"4","author":"Damschroder","journal-title":"Implement Sci"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1186\/s13012-017-0605-9","article-title":"A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems","volume":"12","author":"Atkins","journal-title":"Implement Sci"},{"key":"R19","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0209-1","article-title":"A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project","volume":"10","author":"Powell","journal-title":"Implement Sci"},{"issue":"138","key":"R20","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1002\/ev.20054","article-title":"Pragmatism, evidence, and mixed methods evaluation","volume":"2013","author":"Hall","journal-title":"New Dir Eval"},{"key":"R21","unstructured":"Patton MQ . Qualitative Evaluation and Research Methods. SAGE Publications; 1990. ISBN: 9780803937796"},{"issue":"2","key":"R22","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1057\/ejis.2011.54","article-title":"Pragmatism  interpretivism in qualitative information systems research","volume":"21","author":"Goldkuhl","journal-title":"Eur J Inf Syst"},{"issue":"3","key":"R23","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1080\/08854726.2014.925660","article-title":"Overview of qualitative research","volume":"20","author":"Grossoehme","journal-title":"J Health Care Chaplain"},{"issue":"2","key":"R24","doi-asserted-by":"publisher","first-page":"43","DOI":"10.5296\/ijssr.v5i2.10711","article-title":"What makes qualitative research good research? An exploratory analysis of critical elements","volume":"5","author":"Kalu","journal-title":"Int J Soc Sci Res"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1080\/0142159X.2022.2057287","article-title":"A practical guide to reflexivity in qualitative research: AMEE Guide No. 149","author":"Olmos-Vega","journal-title":"Med Teach"},{"issue":"9","key":"R26","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","journal-title":"Acad Med"},{"issue":"5","key":"R27","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1007\/s10488-013-0528-y","article-title":"Purposeful sampling for qualitative data collection and analysis in mixed method implementation research","volume":"42","author":"Palinkas","journal-title":"Adm Policy Ment Health"},{"issue":"10","key":"R28","doi-asserted-by":"publisher","first-page":"1483","DOI":"10.1177\/1049732318821692","article-title":"What influences saturation? Estimating sample sizes in focus group research","volume":"29","author":"Hennink","journal-title":"Qual Health Res"},{"issue":"2","key":"R29","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1007\/s11136-011-9943-2","article-title":"Individual interviews and focus groups in patients with rheumatoid arthritis: a comparison of two qualitative methods","volume":"21","author":"Coenen","journal-title":"Qual Life Res"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"270","DOI":"10.5195\/jmla.2022.1271","article-title":"NVivo","volume":"110","author":"Dhakal","journal-title":"J Med Libr Assoc"},{"key":"R31","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: a systematic review of empirical tests","volume":"292","author":"Hennink","journal-title":"Soc Sci Med"},{"key":"R32","doi-asserted-by":"publisher","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":"Gale","journal-title":"BMC Med Res Methodol"},{"key":"R33","unstructured":"Quality in qualitative evaluation: a framework for assessing research evidence. United Kingdom Government. 2003. URL: https:\/\/www.gov.uk\/government\/publications\/government-social-research-framework-for-assessing-research-evidence [Accessed 11-12-2025]"},{"issue":"10","key":"R34","doi-asserted-by":"publisher","first-page":"574","DOI":"10.5694\/j.1326-5377.1996.tb138645.x","article-title":"Why we need guidelines for guidelines: a study of the quality of clinical practice guidelines in Australia","volume":"165","author":"Ward","journal-title":"Med J Aust"},{"issue":"1","key":"R35","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13012-021-01171-7","article-title":"Implementability of healthcare interventions: an overview of reviews and development of a conceptual framework","volume":"17","author":"Klaic","journal-title":"Implement Sci"},{"issue":"11","key":"R36","doi-asserted-by":"publisher","first-page":"e2447649","DOI":"10.1001\/jamanetworkopen.2024.47649","article-title":"Patient, caregiver, and clinician perspectives on the time burdens of cancer care","volume":"7","author":"Gupta","journal-title":"JAMA Netw Open"},{"issue":"23-24","key":"R37","doi-asserted-by":"publisher","first-page":"7996","DOI":"10.1111\/jocn.16895","article-title":"The effectiveness of nurse-led care in supporting self-management in patients with cancer: a systematic review","volume":"32","author":"Lanfear","journal-title":"J Clin Nurs"},{"issue":"4","key":"R38","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1111\/jocn.16947","article-title":"Effects of nurse-led self-care interventions on health outcomes among people with heart failure: a systematic review and meta-analysis","volume":"33","author":"Huang","journal-title":"J Clin Nurs"},{"issue":"9","key":"R39","doi-asserted-by":"publisher","first-page":"4255","DOI":"10.1007\/s00520-019-05274-2","article-title":"Implementing routine communication about costs of cancer treatment: perspectives of providers, patients, and caregivers","volume":"28","author":"Haverfield","journal-title":"Support Care Cancer"},{"issue":"10","key":"R40","doi-asserted-by":"publisher","first-page":"3507","DOI":"10.1007\/s00520-018-4218-x","article-title":"Cancer care in regional Australia from the health professional\u2019s perspective","volume":"26","author":"Crawford-Williams","journal-title":"Support Care Cancer"},{"issue":"6","key":"R41","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1111\/ajr.13189","article-title":"Differences in survival of patients with multiple myeloma in rural versus metropolitan regions: analysis of population data of an Australian local health district","volume":"32","author":"Ai","journal-title":"Aust J Rural Health"}],"container-title":["JMIR Research Protocols"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.researchprotocols.org\/2025\/1\/e85053","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:19:07Z","timestamp":1782843547000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.researchprotocols.org\/2025\/1\/e85053"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":41,"URL":"https:\/\/doi.org\/10.2196\/85053","relation":{},"ISSN":["1929-0748"],"issn-type":[{"value":"1929-0748","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]},"article-number":"v14i1e85053"}}