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Establishing Barriers to and Enablers of Nurse-Enabled Subcutaneous Therapy Self-Administration Programs for Patients
Hayley Beer1,2,3, Lisa Guccione3,4, Amit Khot1,4
1Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, 305 Grattan St, Melbourne, Victoria, 3000, Australia, +61 3 85595079.
Background:
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.
Objective:
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.
Methods:
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.
Results:
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.
Conclusions:
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.
