Interventions to Promote Oral Medication Adherence in the PediatricChronic Illness Population: A Systematic Review From the Children’s OncologyGroup

摘要

Pediatric oncology protocols frequently include multiple oral medicationsadministered at varied dosing schedules, often for prolonged periods of time.Nonadherence to protocol-directed oral medications may place patients atincreased risk for morbidity and mortality. The purpose of this systematicreview was to evaluate the existing body of evidence to determine best-practicerecommendations regarding interventions for oral medication adherence inchildren and adolescents with cancer. Twenty-four articles were systematicallyreviewed and evaluated according to the Grading of Recommendations, Assessment,Development, and Evaluation criteria; 2 studies focused on the pediatriconcology population, and the remaining 22 studies focused on other chronicillnesses of childhood. A variety of interventions to increase oral medicationadherence in children were identified, including pill swallowing, technology,incentivization, education-based intervention, psychosocial support-basedintervention, and combination intervention. Most interventions were shown tohave some benefit in pediatrics, most in the non-oncology setting. The overallsynthesis of the literature indicates that nonadherence to oral medications is aprevalent problem in pediatrics, and much work is needed to address thisproblem, particularly in pediatric oncology.