Interventions to Promote Oral Medication Adherence in the Pediatric Chronic Illness Population: A Systematic Review From the Children’s Oncology Group

Abstract

Children and adolescents diagnosed with cancer often require treatment that includes oral medications. These oral medications frequently include both antineoplastic agents essential to cancer treatment and associated supportive care medications. Oral chemotherapy and supportive care regimens are often administered by the child or parent at varied dosing schedules, often for prolonged periods of time (Landier, 2011b). Thus, medication management is an important topic to be addressed with newly diagnosed patients and their parents and is considered a mandatory topic for the pediatric leukemia and lymphoma population (Haugen et al., 2016). Nonadherence to 6-mercaptopurine (6MP), defined as less than 95% adherence to 6MP as prescribed over a period of 6 months, has been associated with a significantly increased risk of relapse in childhood acute lymphoblastic leukemia (ALL) (Bhatia et al., 2012; Bhatia et al., 2014). Pediatric ALL patients who were nonadherent to 6MP demonstrated a 2.7-fold increased 835451J POXXX10.1177/1043454219835451Journal of Pediatric Oncology NursingCoyne et al.

Preventable harm because of outpatient medication errors among children with leukemia and lymphoma: A multisite longitudinal assessment

“…Physician reviewers (Table 3) selected improved communication as a strategy that could have prevented all of errors in this study; specifically, between caregivers and the health system to avoid home administration errors or among members of the health system (e.g., pharmacy, clinician) to prevent prescribing or dispensing errors. Interventions, such as apps or paper materials, are clearly needed to support communication between caregivers at home 2,36 …”

From Unit to Dose: A Machine Learning Approach for Precise Prediction of Hemoglobin and Iron Content in Individual Packed Red Blood Cell Units

“…Forgetfulness and a lack of social support could affect compliance to oral medication in chronically ill pediatric patients. [ 62 ] One possible future application of our method in pediatric patients could be in sickle cell disease (SCD), where many European countries, the U.S.A. and Canada implemented newborn SCD screening programs. [ 63 , 64 ] Our method would not only allow to non‐invasively monitor iron dosage and chelation therapy (Figure S9F , Supporting Information), but could also increase therapy adherence through gamification [ 65 , 66 ] (Figure S9G , Supporting Information) and fewer invasive procedures.…”

Teenagers and Young Adults with Cancer: An Exploration of Factors Contributing to Treatment Adherence

“… Ruddy et al (2009) and Stinson et al (2012) argue that discussing the importance of adherence has also been found to be beneficial, as it may spur those with poor adherence to improve and may encourage those with good adherence to continue. Along with this, they stated that TYAs must be educated in their treatment regimes, to fully understand what they are taking and why ( Coyne et al, 2019 ; Ruddy et al, 2009 ; Stinson et al, 2012 ). The National Service Framework for Children ( Department of Health, 2004 ) advocates this shared decision-making between parents or carers, children or young people, and professionals.…”

“…The active inclusion of the TYAs in this dialogue regarding treatment helps set an atmosphere of compliance. It can improve the professional–patient relationship from compliance (doctor's recommendations) through to adherence (sticking to the plan) to concordance (harmonizing) ( Coyne et al, 2019 ; Horne et al, 2005 ; Windebank & Spinetta, 2008 ).…”

“…It is argued that discussing the importance of adherence has also been found to be beneficial, as it may spur those with poor adherence to improve and may encourage those with good adherence to continue. Through educating TYAs in their treatment regimes, TYAs will be supported to fully understand why the benefits of their treatment outweigh the perceived harm ( Coyne et al, 2019 ; Ruddy et al, 2009 ; Stinson et al, 2012 ).…”