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Measuring Medication Adherence in Pediatric Cancer: An Approach to Validation

Authors :
Jennifer M. Rohan
Linda J. Ewing
Ernest R. Katz
Crista Wetherington Donewar
Dennis Drotar
Melissa A. Alderfer
Alexander A. Vinks
Anna C. Muriel
Tsuyoshi Fukuda
Source :
J Pediatr Psychol
Publication Year :
2015

Abstract

Objective This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP) medication adherence in a multisite cohort of pediatric patients diagnosed with cancer (N = 139). Methods Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Results Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. Conclusions To our knowledge, this was the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric patients with cancer. Using multiple methods of adherence measurement could inform clinical care and target patients in need of intervention.

Details

ISSN :
1465735X
Volume :
42
Issue :
2
Database :
OpenAIRE
Journal :
Journal of pediatric psychology
Accession number :
edsair.doi.dedup.....180395f32189ec65770a50bd2b0fbe05