Open AccessAdherence to Oral Medications During Maintenance Therapy Among Children and Adolescents With Acute Lymphoblastic Leukemia: A Medication Refill Analysis
Author(s) -
Yelena P. Wu,
David D. Stenehjem,
Lauri Linder,
Bin Yu,
Bridget G. Parsons,
Ryan Mooney,
Mark Fluchel
Publication year - 2017
Publication title -
journal of pediatric oncology nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 50
eISSN - 1532-8457
pISSN - 1043-4542
DOI - 10.1177/1043454217741877
Subject(s) - medicine , lymphoblastic leukemia , medication adherence , acute lymphocytic leukemia , maintenance therapy , methotrexate , acute leukemia , intensive care medicine , pediatrics , leukemia , chemotherapy
Adherence to oral medications during maintenance therapy is essential for pediatric patients with acute lymphoblastic leukemia. Self-reported or electronic monitoring of adherence indicate suboptimal adherence, particularly among particular sociodemographic groups. This study used medication refill records to examine adherence among a national sample of pediatric patients with acute lymphoblastic leukemia. Patients in a national claims database, aged 0 to 21 years with a diagnosis of acute lymphoblastic leukemia and in the maintenance phase of treatment, were included. Medication possession ratios were used as measures of adherence. Overall adherence and adherence by sociodemographic groups were examined. Adherence rates were 85% for 6-mercaptopurine and 81% for methotrexate. Adherence was poorer among patients 12 years and older. Oral medication adherence rates were suboptimal and similar to or lower than previously documented rates using other methods of assessing adherence. Refill records offer a promising avenue for monitoring adherence. Additional work to identify groups most at-risk for poor adherence is needed. Nurses are well positioned to routinely monitor for medication adherence and to collaborate with the multidisciplinary team to address barriers to adherence.