Medication Adherence in Adolescent and Young Adult after Hematopoietic Stem Cell Transplant

Abstract

Hematopoietic stem cell transplant is an effective treatment and curative therapy for many oncological, hematological, and immunological diseases. Following hematopoietic stem cell transplant, the management of the prescribed complex treatment regimen may be overwhelming for adolescents and young adults and their caregivers, resulting in non-adherence. In this patient population, adherence to the daily prescribed treatment regimen is estimated at 33 to 73%. Non-adherence to a prescribed medication regimen can lead to reduced treatment efficacy, resulting in suboptimal clinical outcomes and increased healthcare expenditure. The purpose of this evidence-based practice project was to determine if the implementation of adherence promoting interventions combined with the MedActionPlan PRO application and checklist over 12 weeks fosters treatment adherence and self-management of the prescribed medication regimen. Two adolescents and young adults, ages 12 -20 years, who underwent hematopoietic stem cell transplant were enrolled with their caregiver through convenience sampling from the bone marrow transplant unit in a tertiary care pediatric hospital in the Midwest. The intervention included a multicomponent intervention package and a MedActionPlan PRO checklist. The project demonstrated 100 % attendance for adherence focused intervention sessions. Medication adherence through self-report from baseline to post intervention remained unchanged. One participant showed acceptability for intervention sessions as indicated in self-report and endorsed that intervention sessions improved personal organization. Both participants reported feasibility and acceptability of the MedActionPlan PRO checklist.