Addressing Diagnostics Delay in Multiple Myeloma: Insights from a National Survey of Primary Care Providers

BACKGROUND: Our aim was to assess the knowledge, awareness, and confidence of US primary care providers (PCPs) in assessing multiple myeloma (MM) and related plasma cell disorders. METHODS: A survey with quantitative and qualitative questions was conducted from October to December 2024. A total of 560 respondents met the criteria of a representative US PCP cohort, but only 300 respondents were invited to continue the rest of the survey. These respondents had ordered serum protein electrophoresis (SPEP) in the past 12 months and believed that SPEP should be ordered for plasma cell disorder diagnosis. RESULTS: Nearly half of the representative US PCP cohort (46%) do not order tests for plasma cell disorders. Among the 300 who do, there is generally good awareness of symptoms and high-risk characteristics, but only 28% follow guideline-recommended paired testing of SPEP and serum free light chains. The majority (80%) lack confidence in appropriate test selection and interpretation, often relying on peers and hematologists for guidance. Additionally, only 15% of the US PCPs have access to and use myeloma diagnostic ordering sets and panels, while 54% express interest in utilizing such tools. The PCPs identified barriers like insufficient education, collaboration, and specialist support to patient care and outcomes. CONCLUSIONS: The study reveals significant gaps in the understanding and practice of MM diagnostic testing in primary care. Results indicate insufficient knowledge and inadequate utilization of testing guidelines, including low confidence in test ordering and interpretation. The survey suggests a lack of comprehensive, guideline-adherent MM diagnostic panels offered by US laboratories.