Abstract
Previous research suggests that children and adolescents with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) often have difficulty adhering to complex treatment regimens during the maintenance phase of therapy. Measurement of treatment adherence can be done via objective (e.g., electronic monitoring (EM), pharmacological assays) or subjective methods (patient, parent, or physician reports). This paper provides an illustration of recommended strategies for comparing discrepancies between two objective measures of medication adherence (e.g., behavioral adherence using electronic monitoring versus pharmacological adherence using 6-mercaptopurine (6MP) metabolite data) within a relatively large cohort of pediatric patients with ALL or LBL (N = 139) who had longitudinal data for both measures of medication adherence over a 15-month period. Additionally, individual- and family-level factors such as gender, socioeconomic status, household environment, and dose intensity will be examined to identify possible sources of discrepancies between adherence measures. This information will provide practical advice for physicians, healthcare providers, and psychologists in identifying nonadherence and the caveats therein so patients achieve the best possible health outcomes.
Highlights
Importance of Using Novel Objective Measures of Medication AdherenceA pervasive obstacle in managing pediatric chronic illness, including pediatric cancer is treatment nonadherence [1,2,3,4,5,6,7,8,9]
This paper provides an illustration of recommended strategies for comparing discrepancies between two objective measures of medication adherence
The relationship between incongruent adherence results and health outcomes will be examined. This commentary is an extension of a previously published research study that examined the relationship between two objective measures of medication adherence: behavioral adherence (MEMs data) and pharmacological adherence profiles (6MP metabolites) [2]
Summary
A pervasive obstacle in managing pediatric chronic illness, including pediatric cancer is treatment nonadherence [1,2,3,4,5,6,7,8,9]. Many studies have used physician, parent, or patient reported adherence measures or pill counts, which often overestimate adherence levels and are suboptimal measures to identify and target specific nonadherence patterns—especially as such data does not provide objective information, such as the date and time medication was administered or ingested [9,11]. Individual- and family-level factors will be examined to identify possible sources of discrepancies between adherence measures This information will provide practical advice for physicians, healthcare providers, and psychologists in identifying nonadherence and the caveats therein so patients achieve the best possible health outcomes, including disease remission and decreased risk of adverse events
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International Journal of Environmental Research and Public Health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
