Measuring Medication Adherence in Pediatric Cancer: An Approach to Validation. (16th May 2016)

• Record Type: Journal Article
• Authors: Rohan, Jennifer M.; Fukuda, Tsuyoshi; Alderfer, Melissa A.; Wetherington Donewar, Crista; Ewing, Linda; Katz, Ernest R.; Muriel, Anna C.; Vinks, Alexander A.; Drotar, Dennis
• Is Part Of: Journal of pediatric psychology. Volume 42:Number 2(2017)
• Page Start: 232
• Page End: 244
• Publication Date: 2016-05-16
• Subjects: adherence -- cancer -- metabolites -- pediatrics -- pharmacology -- metabolites; Clinical child psychology -- Periodicals; 618.9289005
• DOI: 10.1093/jpepsy/jsw039
• Languages: English
• ISSNs: 0146-8693

Abstract

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.