Implementing Video-Based Education for Multiple Myeloma Patients Preparing for Autologous Stem Cell Transplant: A RE-AIM Evaluation
摘要
Multiple myeloma (MM) is a hematologic cancer that often requires autologous stem cell transplant (ASCT), a complex procedure that places significant self-management demands on patients and caregivers. Many patients report feeling overwhelmed or unprepared for ASCT, particularly regarding tasks like central line care and subcutaneous injections. To address these challenges, a video-based education intervention, Ready for Transplant (R4T), was implemented to supplement standard in-person nurse-led education. This study used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to evaluate implementation over an 18-month study period and 18 months post-study. Observations of 152 clinical encounters, along with interviews with 35 patients and 7 clinicians, informed the evaluation. Findings suggest that the intervention was adopted by nurses and integrated into routine practice, with patients who viewed the videos being more likely to successfully admit for transplant than those who did not (risk ratio = 2.3). Nurses iteratively refined their approach to in-person education based on patient engagement with the videos. The intervention was sustained through the early COVID-19 pandemic, when remote education became especially valuable. R4T appeared particularly helpful for older patients and caregivers who benefited from repeated, on-demand access to key information. This study highlights how patient-centered, flexible education can be successfully implemented and maintained in clinical oncology settings. Video-based supplements may improve both patient readiness and clinician delivery of transplant-related education.