Patient preferences for treatment‑free intervals in multiple myeloma: mixed‑methods insights on monitoring trade‑offs and supportive care improvements

Abstract Purpose Continuous and maintenance therapy remains central to multiple myeloma (MM) care, but repeated treatment-related healthcare encounters may impose physical, psychosocial, and logistical burden. We explored patient preferences regarding intervals between active treatment contacts, monitoring trade-offs, and opportunities to improve inpatient and outpatient care. Methods A 12-month, single-center mixed-methods survey was conducted among 100 patients with MM at a German tertiary center. The survey assessed the perceived importance and preferred length of treatment-free intervals (TFIs), monitoring perceptions, relapse-risk trade-offs, inpatient stressors, and care-improvement proposals. Quantitative responses were summarized with item-specific denominators and exact 95% confidence intervals (CIs). Free-text responses underwent inductive content analysis by two independent raters and mixed-methods integration. Results Intervals between inpatient treatments were rated 10/10 by 49/100 participants (49.0%; 95% CI 38.9–59.2) and 0/10 by 9/100 (9.0%; 95% CI 4.2–16.4). The most frequently reported inpatient stressors were separation from family (27.0%), treatment-related symptoms or side effects (23.0%), and fatigue (17.0%). Regular check-ups were reassuring for 77/100 (77.0%; 95% CI 67.5–84.8) and burdensome for 13/100 (13.0%; 95% CI 7.1–21.2). Seven of 100 participants (7.0%; 95% CI 2.9–13.9) explicitly accepted higher relapse risk for longer TFIs. Preferred minimum interval length was heterogeneous; 39/99 (39.4%; 95% CI 29.7–49.7) preferred > 8 weeks. Qualitative narratives emphasized recovery, autonomy, restoration of routines, and modifiable care-process factors. Conclusion Patients frequently valued intervals between active treatment contacts for recovery, while monitoring was predominantly reassuring. These descriptive findings do not establish the safety or clinical appropriateness of longer TFIs but support prospective evaluation of preference-sensitive scheduling and monitoring.