Medication non‐adherence after allogeneic hematopoietic cell transplantation in adult and pediatric recipients: a cross sectional study conducted by the Francophone Society of Bone Marrow Transplantation and Cellular Therapy

Abstract

Medication non‐adherence (NA) after allogeneic hematopoietic cell transplantation (allo‐HCT) can lead to serious complications. This study assesses NA in French adult and pediatric recipients and identifies factors associated with NA. In accordance with the EMERGE and STROBE guidelines, a cross sectional multicentric survey was conducted. We used a self‐reported questionnaire that was adapted to adults and pediatrics and that could provide a picture of all three phases of medication adherence: initiation, implementation, persistence. We enrolled 242 patients, 203 adults (mean age: 51 years old, 50.7% male) and 39 children (mean age: 9 years old, 56.4% female). Reported NA was estimated at about 75% in both populations, adults and pediatrics. In adults, the univariate analysis showed that patients less than 50 years old (P = 0.041), (i) treated with cyclosporine (P = 0.02), (ii) treated with valacyclovir/acyclovir (P = 0.016), and (iii) experiencing side effects (P = 0.009), were significantly more non‐adherent. In multivariate analysis, only recipient age was significantly associated to NA (P = 0.05). The limited size of the pediatric population did not allow us to draw any statistical conclusion about this population. To the best of our knowledge, this is the first study in France on NA in allo‐HCT recipients. Our results highlight the age factor as the only factor related to NA. Further studies are needed to confirm our observations and refine results in pediatric populations, currently most at risk of medication NA.

Adherence to Immunosuppressive Therapies after Kidney Transplantation from a Biopsychosocial Perspective: A Cross-Sectional Study

“…Nonetheless, some reports suggest that a population of patients with functioning renal transplants tend to have higher AIS scores than patients on hemodialysis or peritoneal dialysis [ 57 ], but acceptance of the illness in patients after KT has been not analyzed as a predictive factor of adherence. Although some researchers suggest that no acceptance of the illness can cause refusal of the treatment [ 33 ], our study showed that patients with functioning renal transplants with higher AIS scores presented better adherence behaviors. However, one should remember that this result is significant only if the regression model does not consider other predictors.…”

“…Nonetheless, the above study did not correlate the Acceptance of Illness Scale (AIS) scores with a standardized measure of adherence. A recent report on patients undergoing immunosuppressive treatment suggests the association between acceptance of illness that considers a new definition of adherence [ 33 ]. This research proposes that the definition of “non-adherence by non-acceptance” implicates that “the patient does not accept the disease and refuses to continue treatment” [ 33 ].…”

“…A recent report on patients undergoing immunosuppressive treatment suggests the association between acceptance of illness that considers a new definition of adherence [ 33 ]. This research proposes that the definition of “non-adherence by non-acceptance” implicates that “the patient does not accept the disease and refuses to continue treatment” [ 33 ]. This strictly implies that acceptance of the illness positively affects adherence behavior in kidney transplant recipients.…”

Medication adherence among allogeneic haematopoietic stem cell transplant recipients: a systematic review protocol

“…In a cross-sectional multicentric study enrolling 203 French adult recipients of an allogeneic HSCT, the MNA rate was 75%. 18 In addition, in a secondary analysis of long-term survivors after an allogeneic HSCT, the authors reported an MNA prevalence rate of 68.7% to immunosuppressants. 8 Various methods have been used to assess medication adherence, which can be categorised into subjective, objective or biochemical measures.…”

“…More recently, a prospective survey conducted by Ice and colleagues4 showed that out of 200 patients, 51% of them were not adherent to non-immunosuppressant medications, and 37.9% were not adherent to oral immunosuppressants. In a cross-sectional multicentric study enrolling 203 French adult recipients of an allogeneic HSCT, the MNA rate was 75% 18. In addition, in a secondary analysis of long-term survivors after an allogeneic HSCT, the authors reported an MNA prevalence rate of 68.7% to immunosuppressants 8…”