Medication adherence among adolescent solid‐organ transplant recipients: A survey of healthcare providers

Abstract

The aim of this study was to assess healthcare provider perspectives on barriers to medication adherence and to discover recommendations for interventions among providers of pediatric solid-organ transplant patients. An anonymous online survey was administered to a multidisciplinary pool of pediatric transplant providers from February 2015 to March 2016. It consisted of 15 questions regarding transplant providers' attitudes, clinical practice, and beliefs pertaining to medication adherence among teenage solid-organ transplant recipients. Data were analyzed using descriptive statistics. Responses to open-ended questions were coded and categorized into themes. One hundred ten surveys were completed by providers specializing in pediatric heart, kidney, liver, lung, and/or intestinal transplantation. Commonly cited reasons for poor adherence were forgetting/poor planning (94%), the desire to be normal (86%), lack of support (86%), and poor parental monitoring (79%). Suggestions to improve adherence included increasing peer and family support, providing education, and incorporating technology into adherence regimens. Barriers to adherence in transplant patients are recognized by providers and are both similar to and disparate from patient and family identified barriers published in the literature. Providers recognize the importance of education, social support, and technologically driven interventions on improving outcomes in the transplant population.

Lung transplant referrals for individuals with cystic fibrosis: A pediatric perspective on the cystic fibrosis foundation consensus guidelines

“…The last topic that we would like to address is the issue of where should adolescents with CF ideally be transplanted—a dedicated pediatric center or a more conveniently located adult center. In analyses of outcomes for every transplanted solid organ, there is evidence that adolescent recipients have the worst outcomes 22–25 . The consensus among authors is that nonadherence is often a determinative factor.…”

Psychologische Grundlagen der pädiatrischen Lebertransplantation

“…In einer aktuellen US-amerikanischen Online-Umfrage [69] unter verschiedenen in der Versorgung jugendlicher Transplantationspatienten tätigen Berufsgruppen wurden von den 110 Teilnehmern Vergesslichkeit und unzureichende Planung am häufigsten (94 %) als Ursache für Medikamenten-Non-Adhärenz genannt, gefolgt von dem Wunsch normal zu sein (86 %) und fehlender Unterstützung (86 %). Die am häufigsten genannten Methoden, um die Adhärenz zu verbessern, waren Schulung bzw.…”

Toward a better understanding: An exploration of provider perceptions in pediatric hematopoietic stem cell transplant adherence

“…Although the literature is scarce in HSCT, non‐adherence to oral medications has been associated with a greater incidence of infections in children during the outpatient treatment phase 16 . Patient‐provider communication has been identified as a contributing factor to adherence, 24 yet few interventions address provider‐driven modifiable factors. While solid organ literature cites differences in perceptions of barriers to adherence among providers, parents, and patients, 24,25 little is known about providers’ perceptions of adherence within the pediatric HSCT population.…”

“…Patient‐provider communication has been identified as a contributing factor to adherence, 24 yet few interventions address provider‐driven modifiable factors. While solid organ literature cites differences in perceptions of barriers to adherence among providers, parents, and patients, 24,25 little is known about providers’ perceptions of adherence within the pediatric HSCT population. Due to the paucity of literature, the purpose of this exploratory study was to better understand the perceptions and experiences of adherence from pediatric HSCT provider perspectives.…”