Adherence to outpatient oral medication regimens in adolescent hematopoietic stem cell transplant recipients

摘要

Purpose: Hematopoietic stem cell transplantation (HSCT) is an increasingly utilized treatment option for adolescents with many life-threatening diagnoses. Suboptimal adherence may result in compromised treatment effectiveness and increased risk of adverse medical outcomes. Method: This study examined adherence patterns in six adolescents (ages 12-18) who had undergone HSCT. Demographic and clinical information were obtained from caregivers and via chart review. Electronic pill bottles (Medical Event Monitors, MEMS?) were used to track medication adherence. Daily, weekly, and monthly adherence as well as medication interruptions (periods of ≥24h between doses) were calculated. Results: Participants took 73% of doses (SD=13%) and demonstrated perfect adherence on 56% of days (SD=18%, Range=34-88%). Average monthly adherence ranged from 40 to 91% and decreased over time. Participants demonstrated at least two [M(SD)=4.20(2.28)] medication interruptions. Individual adherence patterns included high sustained adherence, variable adherence, and delayed non-adherence. Conclusions: Overall, participants struggled to adhere to medication schedules, taking less than three-quarters of prescribed doses and demonstrating perfect adherence on fewer than four out of seven days per week. Adherence rates are similar to those observed in other pediatric populations and demonstrate the importance of routinely assessing adherence in adolescents who have undergone HSCT.