Medication Adherence in Patients with Hematologic Malignancies Who Are Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Study

Amonoo, Hermioni L.; Deary, Emma C.; Wang, Annie C; Newcomb, Richard; Daskalakis, Elizabeth; Weber, Dominique; Holmbeck, Katherine; Choe, Joanna J.; Nabily, Anisa; Cutler, Corey; Traeger, Lara; El‐Jawahri, Areej

doi:10.1016/j.jtct.2023.07.019

Cited by 3 publications

(2 citation statements)

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“…In a recent study evaluating the factors impacting medication adherence in patients with hematologic malignancies who have undergone allogeneic hematopoietic stem cell transplants, although the AEs associated with medication did not directly impact adherence to treatment, they increased the patients' psychological distress. [25] Interestingly, the same study referred that caregiver and clinician support, as well as tools to aid medication management, were factors that facilitated treatment adherence. [25] RITA SaMD can therefore help alleviate stress by providing a way for patients to report their ailments and feel they have clinician support.…”

Section: Discussionmentioning

confidence: 93%

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Use of a Digital Medical Device to Improve Therapeutic Adherence in Patients with Hematological Malignancies: the MargheRITA Study (Preprint)

Ferri,

Dalto,

Romanelli

et al. 2024

Preprint

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BACKGROUND Oncological conditions are a global health challenge, with a substantial number of deaths each year. Treatment adherence is crucial for improving patient outcomes in patients with hematological malignancies, but resource limitations and logistical challenges hinder optimal outpatient management. Digital health solutions, such as the Remote Intelligence for Therapeutic Adherence (RITA) software as medical device (SaMD), offer potential solutions by facilitating telemedicine visits and supporting patients in managing their treatment. OBJECTIVE To evaluate the performance and safety of RITA SaMD in improving patient adherence to treatment protocols for hematological malignancies. METHODS This prospective clinical investigation involved patients with hematological malignancies at ASST Santi Paolo e Carlo in Milan, Italy. The RITA SaMD Group used the RITA platform, while the Control Group comprised historical patients. The primary endpoint was therapeutic adherence to the prescribed drug treatment, defined as at least 80% of the prescribed dose intensity, at Month 3. Secondary endpoints included therapeutic adherence to the prescribed drug treatment at Month 1 and 2, emergency room (ER) visits, adverse events (AEs), and patient-reported outcomes (PROs). Multivariable logistic regression models were used to evaluate the effectiveness of RITA. RESULTS Between July and December 2022, 119 patients were included in the analysis (57 in the RITA SaMD Group and 62 in the Control Group). The probability of being adherent to treatment tended to be higher at all time points in the RITA SaMD Group compared with the Control Group (82.1% vs 80.7% at Month 1, 81.1% vs 76.3% at Month 2, and 85.2% vs 77.1% at Month 3). Multivariable analysis confirmed significantly improved adherence in the RITA SaMD Group at Month 3 [odds ratio (OR): 3.0, 95% confidence interval (CI): 1.0–8.8, P=0.042]. A total of 1476 self-reported AEs were collected through RITA SaMD usage, the majority (N=1080) being Grade 1 events. During the study visits, a total of 20 AEs was recorded by the study physician, 16 in the RITA SaMD Group and 4 in the Control Group. Of the recorded AEs during study visits, 14 were SAEs (11 in the RITA SaMD Group and 3 in the Control Group). None of the reported AEs was considered related to RITA SaMD usage. CONCLUSIONS The MargheRITA clinical investigation showed that after 3 months of using the RITA SaMD, patients with hematological malignancies had 3 times higher OR of being adherent to the prescribed treatment than the Control Group. The use of RITA SaMD facilitated the reporting of AEs and PROs, reinforcing the role of mobile health apps and software in optimizing patient outcomes. Further research is needed to fully understand its interdisciplinary potential and long-term impact on patient outcomes. CLINICALTRIAL ClinicalTrials.gov Identifier NCT05260203

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Section: Discussionmentioning

confidence: 93%

“…[25] Interestingly, the same study referred that caregiver and clinician support, as well as tools to aid medication management, were factors that facilitated treatment adherence. [25] RITA SaMD can therefore help alleviate stress by providing a way for patients to report their ailments and feel they have clinician support.…”

Section: Discussionmentioning

confidence: 93%

Use of a Digital Medical Device to Improve Therapeutic Adherence in Patients with Hematological Malignancies: the MargheRITA Study (Preprint)

Ferri,

Dalto,

Romanelli

et al. 2024

Preprint

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Perspective on oral medication adherence among patients with acute graft-versus-host disease: a qualitative descriptive study

Visintini,

Lucchetta,

Venturini

et al. 2024

Support Care Cancer

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Purpose Despite the importance of adherence to immunosuppressants (IMMs) after an allogeneic haematopoietic stem cell transplant (HSCT) for the treatment of acute graft-versus-host disease (aGvHD), no studies to date have reported the experiences of such patients concerning medication adherence (MA). Therefore, the aim of the study was to explore the perspective on MA to immunosuppressive oral therapy among allogeneic HSCT patients with aGvHD. Methods A qualitative descriptive study following a reflexive thematic analysis methodological approach was performed involving a purposive sample of 16 patients with aGvHD who were being cared for in the outpatient setting of a bone marrow transplant centre and were willing to participate. Semi-structured audio-recorded interviews were conducted, transcribed verbatim and thematically analysed; member checking was performed. COnsolidated criteria for REporting Qualitative research (COREQ) and the ESPACOMP Medication Adherence Reporting Guideline were followed. Results Participants aged 25–74 years and mostly males (62.5%) were recruited for this study; 56.2% developed grade I, 37.5% grade II and 6.3% grade III aGvHD; 56.2% were receiving treatment with both cyclosporine and prednisone. Patients' perspectives have been summarised into four themes, named: “Transiting from an external obligation to a habit”; “Being in the middle between the negative and positive effects of the IMMs”; “Failure to systematically respect the rules”; and “Adopting personal strategies to become adherent”. After difficulties with the perception of feeling obliged, patients became used to adhering to IMMs. Although there were failures in systematically taking the medication correctly and there were episodes of non-adherence, the adoption of personal strategies helped patients to become adherent to their medication schedules. Conclusions MA in patients with aGvHD is a complex behaviour and is often a challenge. These results can help healthcare professionals and centres to understand how best to design tailored strategies and behavioural interventions to maximise patients’ MA to IMMs.

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Overcoming Solubility Challenges: Self-emulsifying Systems for Enhancing the Delivery of Poorly Water-Soluble Antiviral Drugs

Kapoor,

Sharma,

Gaur

et al. 2025

PNT

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The primary goal of drug formulation is to improve a drug’s bioavailability in the body. However, poorly water-soluble drugs present challenging issues related to their solubility and bioavailability factors. Emerging technologies, such as lipid-based drug delivery systems, including micro- or nanoemulsifying drug delivery systems, have become increasingly relevant to address the above challenges. This review presents a thorough overview of self-emulsifying drug delivery systems (SEDDS). It covers the properties, principles, self-emulsification mechanism, formulation strategies, and characterization methods of SEDDS. This review also addresses the delivery of antiviral agents through SEDDS. Moreover, it summarizes the marketed formulations of SEDDS consisting of antiviral agents. This review offers a comprehensive and valuable resource for future perspectives on SEDDS and their potential applications in antiviral drug delivery.

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Medication Adherence in Patients with Hematologic Malignancies Who Are Hematopoietic Stem Cell Transplantation Survivors: A Qualitative Study

Cited by 3 publications

References 70 publications

Use of a Digital Medical Device to Improve Therapeutic Adherence in Patients with Hematological Malignancies: the MargheRITA Study (Preprint)

Use of a Digital Medical Device to Improve Therapeutic Adherence in Patients with Hematological Malignancies: the MargheRITA Study (Preprint)

Perspective on oral medication adherence among patients with acute graft-versus-host disease: a qualitative descriptive study

Overcoming Solubility Challenges: Self-emulsifying Systems for Enhancing the Delivery of Poorly Water-Soluble Antiviral Drugs

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