Can pharmacotherapeutic follow-up after allogeneic hematopoietic stem cell transplantation improve medication compliance?

Abstract

Background Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) is currently one of the most effective therapies in onco-hematology. For the treatment of the disease and prevention of such complications, a complex pharmacotherapeutic regimen is employed. Non-compliance is prevalent among adolescents and young adults with chronic hematological diseases, being reported by up to 50% of the patients. Objective To evaluate the results of pharmacotherapeutic follow-up on medication compliance and on the knowledge about pharmacotherapy of patients who underwent allo-HSCT. Methods A single-arm, open-label and non-randomized intervention study developed in an allo-HSCT outpatient clinic. The participants attended pharmaceutical consultations and had their knowledge about pharmacotherapy and medication compliance measured by MedTake and Brief Medication Questionnaire (BMQ), respectively. Results A total of 27 patients attended pharmaceutical consultations (4.81 consultations/patient; SD = 1.80). There was an improvement in medication compliance and in knowledge between the first and last consultations (p < 0.05). In the final consultation, 70.37% of the patients showed compliance, with a knowledge rate of 98.35% (SD = 3.63). Non-compliant individuals presented a greater tendency to hospital readmissions. There was no relationship between medication compliance and sociodemographic variables, graft-versus-host disease, and knowledge about pharmacotherapy. Conclusions Pharmacotherapeutic follow-up contributed to improving medication compliance. Knowledge about pharmacotherapy alone does not translate into behaviors, which corroborates the complexity of the biopsychosocial factors associated with medication compliance.

Medication Adherence among Allogeneic Haematopoietic Stem Cell Transplant Recipients: A Systematic Review

“…Overall, the male sex was predominant (n = 639, 60.9%). Ethnicity was not reported in 10 studies [5,7,8,11,14,15,[24][25][26]32]; among the remaining studies, Caucasians were the most represented (n = 242, 65.6%).…”

“…To promote MA, in their systematic review, Zanetti and colleagues [23] reported that a clinical pharmacist in the inpatient and outpatient settings may facilitate MA by managing pharmacotherapy-related problems, by discussing with the clinical team and by actively promoting medication reconciliation. This view has also been highlighted in more recent studies [7,[24][25][26]. eHealth [27] has also been investigated in the Swiss SteM-cell-transplantatIon faciLitated by the eHealth (SMILe) Project [28][29][30], where an integrated model of care will be tested (eHealth and a nursing care coordinator) in a hybrid effectiveness-implementation trial, with a focus on MA [31].…”

“…Their main characteristics are summarised in Table S6. Among them, five (35.7%) are cross-sectional [5,6,11,12,14], four (28.6%) are quasiexperimental studies [7,[24][25][26], two (14.3%) are longitudinal [9,15], two are observational studies [8,32] and one (7.1%) is correlational [10]. The studies had been conducted mainly in Europe (n = 6, 42.8%) [5,7,8,14,15,32] and in the US (n = 5, 35.7%) [6,[9][10][11][12].…”

“…The studies had been conducted mainly in Europe (n = 6, 42.8%) [5,7,8,14,15,32] and in the US (n = 5, 35.7%) [6,[9][10][11][12]. The oldest study dated back to 1993 [10], while eight studies (57.1%) had been published since 2020 [5][6][7][8][9]15,25,26]. The majority (n = 8, 57.1%) covered a study duration of ≤1 year [5,6,8,14,[24][25][26]32], although two studies (14.3%) did not report this data [9,10].…”

“…In the 14 included studies, there were a total of 1161 individuals: 1049 adult HSCT recipients, from 23 [24] to 203 [5] transplanted patients per study, and 112 caregivers. The mean patient age ranged from 38.1 years [10] to 56.6 years [6], except for two quasiexperimental studies: in the first [25], most patients in both the experimental and control group were <65 years old (76% and 69%, respectively); in the second study [26] authors reported the mean age of both adult and paediatric patients. Overall, the male sex was predominant (n = 639, 60.9%).…”