Medication nonadherence to immunosuppressants after adult allogeneic haematopoietic stem cell transplantation: a multicentre cross-sectional study

Theory-driven development of a medication adherence intervention delivered by eHealth and transplant team in allogeneic stem cell transplantation: the SMILe implementation science project

“…Results. Particularly regarding immunosuppressive regimes we found medication adherence essential in alloSCT to prevent or treat complications such as acute and chronic GvHD [12,13]. However, almost 65% of participating patients struggled with medication intake, especially immunosuppressants taking and timing (implementation phase of medication adherence) [12] (Table 1).…”

“…For example, taking, timing and dosing immunosuppressants correctly (three behaviors), following food considerations concerning immunosuppressants and not taking drug holidays (implementation dimension). From this list, we selected correct taking and timing of immunosuppressants as the two most Medication non-adherence, which is associated with poor clinical and economic outcomes [20,39], pervades all chronically ill patient populations [12,13,29,40]. Post-alloSCT patients are chronically ill. With a mean of 12 medications [41], their medication regimen is complex.…”

“…Using the ABC taxonomy, medication adherence consists of three interrelated phases: initiation, implementation and persistence [5], the latter two being relevant after alloSCT. Implementation adherence includes correct taking, timing, dosing, no drug holidays and correct food considerations (e. g., no grapefruit juice) [5,12]. While available evidence on medication adherence in alloSCT populations is limited, we know that the prevalence of overall non-adherence to immunosuppressants in adult alloSCT patients is 64.6%: 33.3% taking non-adherence, 61.2% timing non-adherence, 4.1% dosing non-adherence, 3.2% drug holidays and 3.1% discontinuation [12].…”

“…The correlation is extremely compelling: In patients without chronic GvHD only 15.6% showed medication non-adherence to immunosuppressants while in patients with mild GvHD already 66.7% were non-adherent. In patients with moderate GvHD 74.1% showed medication non-adherence and in patients with severe GvHD even 88.9% were non-adherent [12]. As alloSCT receive their first doses of immunosuppressants during their hospitalization, the initiation phase of adherence is not an issue [6,7]; adherence enhancing interventions need to focus on post-discharge implementation and persistence of medication intake [12].…”

ecancermedicalscience

“…Also this year, the Committee has shown that it carries on aiming to improve the care of paediatric and adolescent SCT patients and to promote, develop, and share knowledge between paediatric nurses. The participants contributed to the success of this edition with questions, observations, and comments, and, in particular, with visible enthusiasm, which ended with the award of the best poster and best oral presentation abstracts: they went respectively to ‘Evaluation of a discharge booklet for allograft patient’ by Tardieu et al [2] with the participation of 37 French centres and ‘Medication non-adherence to taking immunosuppressant's after allogenic hematopoietic stem cell transplantation is associated with cGVHD: PROVIDOMED—a multicentre cross-sectional study’ conducted by Gresch et al [3] in Basel, Switzerland.…”