Understanding barriers to oral medication adherence in adults with acute myeloid leukemia (AML).

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 106-106
Author(s):  
Ashley Leak Bryant ◽  
Ya-Ning Chan ◽  
Jaime Richardson ◽  
Matthew Charles Foster ◽  
Debra Wujcik
Keyword(s):  
Medication Adherence ◽  
Treatment Effectiveness ◽  
Health Care Team ◽  
Oral Medication ◽  
Subjective Feeling ◽  
Sources Of Information ◽  
Oral Medications ◽  
Gift Cards ◽  
Interview Guide ◽  
Toxicity Risk

106 Background: AML is a disease of older adults (median age 67 years). Although standard AML treatment is intravenous (IV) chemotherapy, availability of oral anti-cancer medications has increased , providing benefits and risks to patients. Patients prefer their convenience, absence of IV infusions, potential for fewer clinic visits, and increased subjective feeling of control over their disease. Poor adherence can increase toxicity risk and compromise treatment effectiveness. We aim to identify barriers to adherence to oral medications in patients with AML and proposed solutions for improvements. Methods: Following IRB approval, patients with AML and their caregivers were recruited to participate in focus groups. An experienced moderator conducted the groups using an interview guide developed by AML experts. Participants received gift cards for their participation. Sessions were digitally recorded, transcribed verbatim, and analyzed for thematic content using Dedoose qualitative software. Results: 11 patients (5 <65 years; 6 >65 years) and 4 caregivers participated in sessions lasting 60-75 minutes. Three central themes emerged: medication adherence challenges, managing an oral adherence plan, and strategies to improve oral adherence. Adherence challenges: number and size of pills, different directions, cost, availability, and side effects. An adherence plan was recommended: written schedules, take medications around meals, and use of pillboxes and alarms. Main sources of information: health care team and bottle directions. Recommendations for providing adherence assistance included better instructions, assistance with scheduling, making pills smaller, and consistency in packaging. Conclusions: Patients are an important source of insight into barriers and solutions to oral medication adherence. These responses were used to develop a survey to be administered to 100 patients with AML. Results will inform development of an intervention to improve oral medication adherence in the AML population.

scholarly journals Interventions to Promote Oral Medication Adherence in the Pediatric Chronic Illness Population: A Systematic Review From the Children’s Oncology Group

2019 ◽  
Vol 36 (3) ◽  
pp. 219-235 ◽  
Author(s):  
Kelly D. Coyne ◽  
Katherine A. Trimble ◽  
Ashley Lloyd ◽  
Laura Petrando ◽  
Jennie Pentz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Medication Adherence ◽  
Pediatric Oncology ◽  
Best Practice ◽  
Psychosocial Support ◽  
Evaluation Criteria ◽  
Oral Medication ◽  
Assessment Development ◽  
Oral Medications ◽  
Increased Risk

Pediatric oncology protocols frequently include multiple oral medications administered at varied dosing schedules, often for prolonged periods of time. Nonadherence to protocol-directed oral medications may place patients at increased risk for morbidity and mortality. The purpose of this systematic review was to evaluate the existing body of evidence to determine best-practice recommendations regarding interventions for oral medication adherence in children and adolescents with cancer. Twenty-four articles were systematically reviewed and evaluated according to the Grading of Recommendations, Assessment, Development, and Evaluation criteria; 2 studies focused on the pediatric oncology population, and the remaining 22 studies focused on other chronic illnesses of childhood. A variety of interventions to increase oral medication adherence in children were identified, including pill swallowing, technology, incentivization, education-based intervention, psychosocial support-based intervention, and combination intervention. Most interventions were shown to have some benefit in pediatrics, most in the non-oncology setting. The overall synthesis of the literature indicates that nonadherence to oral medications is a prevalent problem in pediatrics, and much work is needed to address this problem, particularly in pediatric oncology.

scholarly journals Manipulations of Oral Medications in Paediatric Neurology and Oncology Care at a Swedish University Hospital: Health Professionals’ Attitudes and Sources of Information

Pharmaceutics ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 1676
Author(s):  
Rania Kader ◽  
Gunnar Liminga ◽  
Gustaf Ljungman ◽  
Mattias Paulsson
Keyword(s):  
Enteral Feeding ◽  
Product Information ◽  
Feeding Tube ◽  
Paediatric Oncology ◽  
Working Environment ◽  
University Hospital ◽  
Hazardous Substances ◽  
Oral Dosage ◽  
Sources Of Information ◽  
Oral Medications

Oral administration of medications to children requires age-appropriate dosage forms and strengths. In this study, we: (i) assessed the extent of oral dosage form manipulations, (ii) documented how it is carried out, and (iii) examined the attitudes and sources of information regarding the handling from healthcare professionals. Prospective reviews of electronic records, ward observations, and clinician surveys were performed at a paediatric neurology ward and a paediatric oncology ward in Sweden during April to May of 2018. Approximately 15% of oral medications were manipulated for the studied patient group (median age 12.9 years in oncology, 5.8 years in neurology) with approximately 30% of the patients having an enteral feeding tube. Manipulations were performed both to obtain an appropriate dose from, for example, a fraction of the original tablet or to obtain a powder that could be used to prepare a slurry for administration through enteral feeding tubes. Risks identified were related to patient safety such as cross contamination, suboptimal absorption/pharmacokinetics and inaccurate dose. When examining the working environment of nurses, we observed safe handling of hazardous substances but the nurses occasionally experienced stress and a fear of making mistakes due to absence of information. Paediatricians experienced a lack of time to search for proper information on manipulations. As a step towards improving safety in paediatric medication, we suggest the introduction of clinical pharmacists into the team and further evaluating the possibilities of using more ready-to-administer medications with necessary product information and pharmacovigilance support.

scholarly journals Barriers to Oral Medication Adherence for Adolescents with Inflammatory Bowel Disease

2009 ◽  
Vol 35 (6) ◽  
pp. 683-691 ◽  
Author(s):  
L. M. Ingerski ◽  
R. N. Baldassano ◽  
L. A. Denson ◽  
K. A. Hommel
Keyword(s):  
Inflammatory Bowel Disease ◽  
Medication Adherence ◽  
Bowel Disease ◽  
Oral Medication ◽  
Inflammatory Bowel

scholarly journals It's not all about inhaled treatment: challenges with oral therapy in paediatric respiratory medicine

Breathe ◽  
2021 ◽  
Vol 17 (1) ◽  
pp. 210005
Author(s):  
Anneka Sareen ◽  
Manisha Ramphul ◽  
Jayesh Mahendra Bhatt
Keyword(s):  
Cystic Fibrosis ◽  
Survival Rates ◽  
Paediatric Population ◽  
Oral Medication ◽  
Respiratory Medicine ◽  
Oral Drug ◽  
List Type ◽  
Treatment Burden ◽  
Oral Medications ◽  
Oral Formulations

Advances in therapies and management of conditions encountered by paediatric respiratory specialists have led to improved outcomes and improved survival rates dramatically in chronic diseases such as cystic fibrosis. However, this has also meant an increase in treatment burden. A variety of inhaled treatments are crucial in managing paediatric respiratory diseases, but these patients also have to take many oral medications. It is widely recognised that developing oral formulations appropriate for the paediatric population can affect how well a product is received by patients and their families. Consideration should be given to palatability and the number of medicines to be administered as these can all contribute to treatment adherence.Polypharmacy specifically in the context of management of patients with cystic fibrosis is not a new concept, but the recently introduced cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies and their potential for interactions and adverse reactions create novel challenges. There are some strategies that families and healthcare professionals can implement to reduce treatment burden. This review will also provide some insight into the life of a teenager with cystic fibrosis and the relative complexities of her treatment and the impacts on daily life.Educational aimsTo describe the difficulties faced by children with long-term respiratory conditions having to take oral medication.To discuss oral drug interactions that may exist within paediatric respiratory medicine and to consider issues with polypharmacy.To highlight strategies that may be used to reduce the burden of care for children on oral medication.

Oral medication adherence in cancer interventional studies.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e17505-e17505
Author(s):  
Catherine Lam ◽  
Meaghann Shaw Weaver ◽  
Scott C. Howard
Keyword(s):  
Medication Adherence ◽  
Oral Medication

Medication Adherence Interview Guide

2016 ◽  
Author(s):  
Angelia M. Paschal ◽  
Qshequilla P. Mitchell ◽  
Jereme D. Wilroy ◽  
Suzanne R. Hawley ◽  
Jermaine B. Mitchell
Keyword(s):  
Medication Adherence ◽  
Interview Guide

SECONDARY IMMUNODEFICIENCY STATES IN THE ACTIVITY OF A GENERAL PRACTITIONER – FAMILY MEDICINE AND PHYTOTHERAPEUTICWAYS OF THEIR CORRECTION (LECTURE)

Fitoterapia ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 6-15
Author(s):  
O Voloshуn ◽  
◽  
L Voloshyna ◽  
B Senyuk ◽  
I Prуsyazhnyuk ◽  
...  
Keyword(s):  
Primary Care Physicians ◽  
Treatment Effectiveness ◽  
Folk Medicine ◽  
Clinical Signs ◽  
Treatment Strategies ◽  
Sources Of Information ◽  
Secondary Immunodeficiency ◽  
Results Of Treatment ◽  
Treatment And Prevention ◽  
Immunodeficiency States

Keywords: secondary immunodeficiency states, diagnosis, treatment, phytoimmunomodulators. Topicality. Secondary immunodeficiency states (SIS) is a fairly common phenomenon in the clinic of internal medicine as an “addition” for many diseases, which has no clear clinical signs, so it is not often diagnosed by primary care physicians. However, untimely detection and correction of SI significantly worsens the overall results of treatment and contributes to recurrence of the underlying disease.There is a prospect of further increase in the prevalence of SI, the success of correction of underlying desease due to doctors’ understanding of their clinical and pathogenetic features and knowledge of treatment strategies and tactics, including the use of phytotherapeutic agents. The aim is to highlight modern approaches to the diagnosis and treatment of SI with the use of phytotherapeutic agents. Materials and methods. Materials of the main domestic and foreign printed sources of information using methods of comparison, analysis and generalization are used. Results. Information on the classification, diagnosis, strategy and tactics of treatment and prevention of SIS depending on their severity with the use of various phytotherapeutic agents, criteria for treatment effectiveness, age and somatic aspects of rehabilitation at the outpatient stage are analyzed. The importance of timely diagnosis of secondary immunodeficiency and the use of phytotherapeutic agents in the context of the “WHO Strategy in the field of folk medicine for 2014-2023” as the latest and most effective approach in the treatment of complex pathological phenomena.

Sign in / Sign up

Export Citation Format

Share Document