Jennifer M Rohan1, Dennis Drotar2, Melissa Alderfer3, Crista Wetherington Donewar3, Linda Ewing3, Ernest R Katz3, Anna Muriel3. 1. Department of Psychology, University of Cincinnati, USA, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, USA, The Cancer Center, Children's Hospital of Philadelphia, USA, Department of Psychiatry, Children's Hospital Medical Center, USA, Department of Psychiatry, Western Psychiatric Institute and Clinic, USA, Division of Hematology-Oncology and Blood & Marrow Transplant, Children's Hospital Los Angeles, USA, and Adolescent Psychiatry & Pediatric Psychiatry, Dana-Farber/Children's Hospital Cancer Center, USA Department of Psychology, University of Cincinnati, USA, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, USA, The Cancer Center, Children's Hospital of Philadelphia, USA, Department of Psychiatry, Children's Hospital Medical Center, USA, Department of Psychiatry, Western Psychiatric Institute and Clinic, USA, Division of Hematology-Oncology and Blood & Marrow Transplant, Children's Hospital Los Angeles, USA, and Adolescent Psychiatry & Pediatric Psychiatry, Dana-Farber/Children's Hospital Cancer Center, USA rohanjenm@gmail.com. 2. Department of Psychology, University of Cincinnati, USA, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, USA, The Cancer Center, Children's Hospital of Philadelphia, USA, Department of Psychiatry, Children's Hospital Medical Center, USA, Department of Psychiatry, Western Psychiatric Institute and Clinic, USA, Division of Hematology-Oncology and Blood & Marrow Transplant, Children's Hospital Los Angeles, USA, and Adolescent Psychiatry & Pediatric Psychiatry, Dana-Farber/Children's Hospital Cancer Center, USA Department of Psychology, University of Cincinnati, USA, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, USA, The Cancer Center, Children's Hospital of Philadelphia, USA, Department of Psychiatry, Children's Hospital Medical Center, USA, Department of Psychiatry, Western Psychiatric Institute and Clinic, USA, Division of Hematology-Oncology and Blood & Marrow Transplant, Children's Hospital Los Angeles, USA, and Adolescent Psychiatry & Pediatric Psychiatry, Dana-Farber/Children's Hospital Cancer Center, USA. 3. Department of Psychology, University of Cincinnati, USA, Center for Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, USA, The Cancer Center, Children's Hospital of Philadelphia, USA, Department of Psychiatry, Children's Hospital Medical Center, USA, Department of Psychiatry, Western Psychiatric Institute and Clinic, USA, Division of Hematology-Oncology and Blood & Marrow Transplant, Children's Hospital Los Angeles, USA, and Adolescent Psychiatry & Pediatric Psychiatry, Dana-Farber/Children's Hospital Cancer Center, USA.
Abstract
OBJECTIVE: To describe patterns of treatment adherence to early maintenance phase therapy for acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL). METHODS: Using an objective observational method (electronic monitoring), adherence was examined for 139 patients aged 7-19 years diagnosed with ALL or LBL across 6 centers. RESULTS: The mean adherence percentage was 86.2%. Adherence rates declined over the 1-month of follow-up to 83%. 3 linear trajectories of 6-mercaptopurine adherence were identified: (1) exemplary adherence (n = 99): Averaging nearly 100%; (2) deteriorating (n = 23): Adherence decreased from 100 to 60%; and (3) chronically poor adherence (n = 9): Averaging 40%. CONCLUSIONS: Adherence promotion interventions might be tailored to subgroups of patients who demonstrated problematic patterns of treatment adherence that could place them at risk for relapse. This research demonstrates the importance of using objective real-time measures of medication adherence for measuring and documenting adherence patterns.
OBJECTIVE: To describe patterns of treatment adherence to early maintenance phase therapy for acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL). METHODS: Using an objective observational method (electronic monitoring), adherence was examined for 139 patients aged 7-19 years diagnosed with ALL or LBL across 6 centers. RESULTS: The mean adherence percentage was 86.2%. Adherence rates declined over the 1-month of follow-up to 83%. 3 linear trajectories of 6-mercaptopurine adherence were identified: (1) exemplary adherence (n = 99): Averaging nearly 100%; (2) deteriorating (n = 23): Adherence decreased from 100 to 60%; and (3) chronically poor adherence (n = 9): Averaging 40%. CONCLUSIONS: Adherence promotion interventions might be tailored to subgroups of patients who demonstrated problematic patterns of treatment adherence that could place them at risk for relapse. This research demonstrates the importance of using objective real-time measures of medication adherence for measuring and documenting adherence patterns.
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