IMF Nurse Leadership Board (NLB) Survivorship Care Plan for Multiple Myeloma
Patients with myeloma are surviving longer and, therefore, may experience continuing effects of their disease and treatment. Through clinical experience, the International Myeloma Foundation Nurse Leadership Board (NLB) was aware that a specific set of needs exists in this patient population. Identification of these needs, and stressing the importance of prompt intervention, could lead to improvement in their quality of life and overall survival.
The NLB identified the most significant needs of patients diagnosed with multiple myeloma as bone health, health maintenance, mobility and safety, sexual dysfunction, and renal health. They then developed a survivorship care plan to assist healthcare providers and patients with multiple myeloma, their partners, and their caregivers to identify these needs.
About 90% of individuals with myeloma will develop osteolytic bone lesions from increased osteoclastic and decreased osteoblastic activity. Supportive care targeting bone disease is an essential adjunct to antimyeloma therapy. In addition, the maintenance of bone health in patients with multiple myeloma can significantly improve quality of life
Patients with multiple myeloma are at risk for illnesses experienced by the general population and at additional risk for illnesses related to multiple myeloma and its treatment. Therefore, the NLB has developed practice recommendations to meet the particular needs of adult patients with multiple myeloma using evidence-based recommendations for screening and disease prevention, as well as nursing experience.
Although mobility challenges vary among survivors of myeloma, patients have an increased risk of impaired mobility because of side effects of therapy and the pathology of the disease, as well as other factors (e.g., increasing age). Health maintenance increasingly is becoming a part of the cancer control continuum, and nurses have the opportunity to help survivors of multiple myeloma optimize their functional mobility and safety, thereby preserving quality of life.
In this article, members of the NLB present evidence-based practice recommendations that have been developed for promoting dialogue and assessment, education, and management practices among patients with multiple myeloma and their healthcare providers and partners.
Kidney dysfunction is a common clinical feature of symptomatic multiple myeloma. Some degree of renal insufficiency or renal failure is present at diagnosis or will occur during the course of the disease and, if not reversed, will adversely affect overall survival and quality of life. The NLB has developed practice recommendations for screening renal function, identifying risk and environmental factors, selecting appropriate therapies and supportive care measures.