Related Experiment Video

Updated: Dec 8, 2025

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS
08:38

Quantification of the Immunosuppressant Tacrolimus on Dried Blood Spots Using LC-MS/MS

Published on: November 8, 2015

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Transplantation and Adherence: Evaluating Tacrolimus Usage in Pediatric Patients With Cancer

Micah A Skeens1, Mary S Dietrich2, Nancy Ryan-Wenger3

  • 1Nationwide Children's Hospital.

Clinical Journal of Oncology Nursing
|September 18, 2020
PubMed

Insights

Pediatric patients with chronic illness often struggle with tacrolimus adherence, impacting hematopoietic stem cell transplantation (HSCT) outcomes. This study highlights significant gaps in adherence documentation and high rates of nontherapeutic drug levels.

Area of Science:

  • Pediatric Hematology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Tacrolimus is crucial for preventing adverse effects in hematopoietic stem cell transplantation (HSCT).
  • Approximately 50% of pediatric patients with chronic illnesses adhere to tacrolimus therapy.
  • Poor adherence can lead to critical complications post-HSCT.

Purpose of the Study:

  • To evaluate patient adherence to tacrolimus therapy.
  • To assess adherence through electronic health records and therapeutic drug monitoring.
  • To identify challenges in tacrolimus adherence among pediatric HSCT patients.

Main Methods:

  • Retrospective descriptive study of 357 clinic visits from 57 pediatric patients undergoing HSCT.
  • Evaluation of direct (tacrolimus levels) and indirect (patient reporting) adherence measures.
  • Analysis of electronic health record documentation for adherence data.

Main Results:

  • Adherence was not documented in 51% of patient visits.
  • A significant rate of 60% for nontherapeutic tacrolimus drug levels was observed.
  • Nonadherence did not statistically correlate with nontherapeutic levels due to sample size limitations.

Conclusions:

  • Clinical practice requires improved awareness, assessment, and documentation of tacrolimus adherence.
  • The findings underscore the need for better strategies to ensure medication adherence in pediatric HSCT.
  • Further research is needed to understand and address the barriers to tacrolimus adherence.
Abstract

Keywords:
HSCTadherenceimmunosuppressionpediatric stem cell transplantationtacrolimus

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