Bone Health, Pain, and Mobility: Evidence-Based Recommendations for Patients With Multiple Myeloma

Sandra Rome, RN, MN, AOCN®, CNS; Kimberly Noonan, RN, MS, CNP, AOCN®; Page Bertolotti, RN, BSN, OCN®; Joseph D. Tariman, PhD, RN, ANP-BC, FAAN,; Teresa Miceli, BSN, RN, OCN®


Background: About 85% of patients with multiple myeloma develop bone disease. In these patients, lytic bone lesions can cause fractures, poor circulation, blood clots, pain, poor mobility, and decreased quality of life.

Objectives: This article presents consensus statements to guide nurses in the assessment and management of bone disease, pain, and mobility in patients with multiple myeloma at varying points in their disease trajectory.

Methods: Members of the International Myeloma Foundation Nurse Leadership Board reviewed previously provided recommendations, current recommendations based on literature review, and evidence-based grading.

Findings: Oncology nurses play a key role in maximizing bone health, minimizing skeletal injury, maximizing pain control, and improving quality of life in patients by enhancing patient mobility and safety. Clinician assessment accompanied by effective interventions reduces patient injury and optimizes functioning in patients with multiple myeloma.

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