Establishing barriers and enablers to nurse-enabled, subcutaneous therapy self-administration programs for myeloma patients: Protocol for a qualitative, descriptive study (Preprint)

<sec> <title>BACKGROUND</title> 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 to suggest 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. </sec> <sec> <title>OBJECTIVE</title> This study will explore and describe barriers and enablers to implementing nurse-enabled SC therapy self-administration programs for patients with MM to develop a Roadmap for national scalability. </sec> <sec> <title>METHODS</title> This qualitative descriptive study is informed by the Consolidated Framework for Implementation Research (CFIR). Participants will include key stakeholders from across Australia, including patients, carers, health professionals and policy makers with experience of implementation, facilitation and participation in nurse enabled, SC therapy self-administration programs. Data will be collected via virtual focus groups or semi-structured interviews and analyzed using the Framework Method to identify barriers and enablers. The Expert Recommendations for Implementing Change matching tool will be used to development strategies to target barriers and enhance enablers, informing the development of a national Roadmap. </sec> <sec> <title>RESULTS</title> Not applicable, protocol only </sec> <sec> <title>CONCLUSIONS</title> To our knowledge, this study will be the first of its kind to identify and compare barriers and enablers to implementing nurse-enabled SC self-administration programs for patients with MM. Applying the CFIR to guide the study provides an evidence-informed approach to understanding how discrete and intersecting factors influence program implementation and sustainability, informing development of a comprehensive implementation Roadmap. The implications of this work extend beyond MM. As the availability of SC therapies for other cancers and chronic diseases grows, this model of care could serve as a blueprint for broader applications, impacting patient quality of life (QoL) and optimization of healthcare utilization. </sec>