Poor Adherence Is Associated with More Infections after Pediatric Hematopoietic Stem Cell Transplant

Area of Science:

• Pediatric Hematology
• Transplant Medicine
• Pharmacology

Background:

• Adherence to oral medications is crucial for pediatric patients post-hematopoietic stem cell transplant (HSCT).
• Limited data exists on long-term outpatient oral medication adherence rates in this vulnerable population.

Purpose of the Study:

• To prospectively evaluate oral medication adherence in children following HSCT.
• To investigate the association between medication adherence and infection rates in pediatric HSCT recipients.

Main Methods:

• Prospective study involving 50 pediatric patients (0-16 years) and caregivers.
• Electronic pill bottles used to track medication adherence for 6 months post-discharge.
• Adherence calculated as prescribed doses vs. doses taken; data correlated with infection rates.

Main Results:

• Average adherence decreased from 63% at 1 month to 57% at 6 months post-discharge.
• Lower adherence was significantly associated with higher infection rates in allogeneic HSCT recipients (P < .005).
• No significant association between adherence and infection rates was observed in autologous HSCT recipients.

Conclusions:

• Poor oral medication adherence is common and persistent in children post-HSCT.
• Reduced adherence, particularly in allogeneic HSCT, is linked to increased infection incidence.
• Further research and interventions are needed to improve medication adherence throughout the HSCT treatment course.