Background The dramatic improvement in the survival of multiple myeloma (MM) patients has led to an increased emphasis on their QoL, which unfortunately has been evaluated with tools that are inadequate and outdated. Traditional patient reported outcomes (PRO) methods are episodic, burdensome, and rarely integrated into actionable workflows. mQOL (www.mqol.com) addresses this shortcoming through a HIPAA-compliant, SMS-based remote therapeutic monitoring (RTM) platform on a smartphone, delivering personalized, high-frequency symptom evaluation and QoL tracking without requiring patients to download an app. mQOL supports proactive clinical care by transforming patient experiences into real-time, structured data streams that empower clinicians to improve patient care. This may facilitate earlier recognition of status changes and enable more timely clinical interventions, leading to improved outcomes.

Methods We conducted a single-center, prospective observational study (MQ-mQOL-001) which enrolled MM patients across three cohorts: newly diagnosed (ND), relapsed/refractory (RR), and maintenance (M). Using the mQOL platform, patients received scheduled SMS prompts to assess commonly expected Sxs in the following cadence:

• ND: QD for 30 days followed by Qweek until done

• RR: QD for 30 days followed by Qweek until done

• M: Qweek throughout

Additionally, based on 10 QoL questions selected from the EORTC-QLQ-C30 validated domains, we administered an assessment on an every 14 day schedule. We used EORTC scoring (1-Not at all; 2-A little: 3-Quite a bit: 4-Very much) to assess severity. Potential actionable events included an increase of > 2 and any value of 4. Patients completed Sx and QoL check-ins by text for 90 days. Visualizations were provided via automated reports. Time burden, adherence, response dynamics, and flagged events were captured with completion rates, time requirement, and data utility analyzed. A digital dashboard aggregated data daily and alerted clinicians to potential actionable trends.

Results Between March 27, 2025 and June 29, 2025, 58 patients were enrolled across three cohorts: Front-line (n=1), relapsed/refractory (n=21), and maintenance (n=36). The median age was 68, and 67% of participants were male. Across the study period, 9,322 questions were asked via SMS, 7,062 related to Sx and 2,260 related to QoL. These were delivered through 860 Sx check-ins and 251 QoL assessments.

Completion rates were high across all cohorts. Sx adherence averaged 90% (MAINT: 91%, RRMM: 88%), and QoL adherence averaged 90% (MAINT: 91%, RRMM: 87%). Surveys required less than 3 minutes on average to complete, with minimal variation by age or gender.

The most frequently reported symptoms (rated > 2) were fatigue (52.9% of responses), bone pain (47.2%), general pain (44.9%), insomnia (42.2%), and psychosocial distress (41.1%). Corresponding mean EORTC-QLQ-C30 scores included drowsiness/fatigue (1.89), pain (1.80), neuropathy (1.74), insomnia (1.71), psychosocial distress (1.50), and tiredness (1.75). More than 200 alert-triggering events (e.g., increase of > 2 and any value of 4) were identified and transmitted to the clinical team within 24 hours. Of these, 44% were acted upon, enabling earlier interventions to support patient care. The remaining 56% were repetitive and not require action by the practice.

Conclusions In this prospective study, we have demonstrated that the utility of mQOL, a HIPAA-compliant, SMS-based PRO collection platform, is feasible, timely, and actionable, supporting earlier interventions and more personalized care for MM patients. Specifically, it can lead to potentially more rapid adjustments in clinical management, including dose modifications, supportive care initiation, and earlier intervention for emerging toxicities. The mQOL platform is easy to use and improves the collection rate, timeliness and clinical utility of PRO for MM patients. High completion rates and real-time alerting of practices facilitate proactive care,reduce response time and create a new way for patient engagement and physician decision making.This is mutually beneficial to MM patients and healthcare professionals for more rapid management of changes in symptoms and QoL. Notably, mQOL offers a scalable solution for integrating the patient voice into daily clinical care. . Finally, the mQOL platform provides the opportunity to get a more realistic view of the patient's experience with their disease and treatments.

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2025
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