Barreras multidimensionales en el acceso a la medicación para pacientes con mieloma múltiple en el sector urbano de Riobamba

Abstract

This study analyzes the barriers faced by patients with multiple myeloma in accessing medication in the urban area of Riobamba, with the aim of identifying the social, economic, and structural factors that shape their personal and family experience after diagnosis. The methodology applied a qualitative approach using life stories and interviews with four patients selected for convenience, analyzing the information with ATLAS.ti software. The results showed that diagnosis constitutes a biographical rupture and loss of life plans. The family becomes the main source of care, causing overload and changes in the dynamics of the home. Faced with limited institutional response, patients turn to community networks and spiritual resilience. In addition, the health system faces significant limitations, including drug shortages and the centralization of specialized services in Quito and Guayaquil. Added to these difficulties are the high costs of medication and transportation, which exceed the basic salary and generate a heavy economic burden. In conclusion, social work in health is essential to mediate between families and institutions, reduce bureaucracy, strengthen support networks, and highlight structural inequalities that affect access