Digital Symptom Reporting for Treatment Readiness Before Daratumumab: A Blinded Prospective Study in Multiple Myeloma

Objectives: For patients with multiple myeloma (MM), an increasing proportion of treatment is now delivered at home. While this shift offers convenience and supports continuity of care, it also demands new ways to ensure patient safety outside the hospital. Although patients receiving home-based treatment are generally clinically stable, each administration still requires a pre-treatment safety assessment, traditionally performed by telephone. We aimed to evaluate whether digital patient-reported outcomes (PROs) could replace these calls to determine treatment readiness. Methods: This feasibility study included 30 patients (median age 76 years, 60% male). Prior to each scheduled treatment, patients completed a digital symptom questionnaire. An algorithm stratified patients according to treatment readiness. In total, 233 questionnaires were distributed and 179 completed (completion rate 77%). Healthcare professionals were blinded to PRO data during the study, and PRO-based assessments were compared with standard nurse-led telephone evaluations after study completion. Results: Digital PRO data reliably identified patients ready for treatment. The algorithm achieved a positive predictive value of 100%, indicating concordance between PRO-based readiness classification and clinical decisions. The negative predictive value was 19%, reflecting that most patients reporting symptoms were ultimately eligible for treatment. Overall, nearly 80% of routine pre-treatment telephone calls could safely be omitted without compromising patient safety. Conclusions: This study suggests that digital PRO-based symptom reporting may support a reduction in routine pre-treatment telephone assessments for selected patients with MM receiving daratumumab. The approach showed potential for streamlining clinical workflows while maintaining patient safety, although confirmatory studies are needed before implementation.