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Pediatric Hematopoietic Stem Cell Transplant Medication Adherence Facilitators and Strategies: A Qualitative Study

Marie L Chardon1, Kimberly L Klages1, Naomi E Joffe1,2,3

  • 1Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, USA.

Journal of Pediatric Psychology
|September 29, 2022
PubMed

Insights

Caregivers of children undergoing hematopoietic stem cell transplant (HCT) develop many strategies for medication adherence. However, caregiver burden remains high, indicating a need for tailored multidisciplinary support post-HCT.

Area of Science:

  • Pediatric Hematology/Oncology
  • Transplantation Medicine
  • Adolescent and Young Adult Medicine

Background:

  • Medication adherence is critical for pediatric survival post-hematopoietic stem cell transplant (HCT).
  • Suboptimal adherence is a common challenge in this vulnerable population.
  • Understanding facilitators and strategies is essential for developing effective interventions.

Purpose of the Study:

  • To examine caregiver-perceived medication adherence facilitators and strategies after pediatric HCT.
  • To identify factors that promote or hinder medication management in children post-transplant.
  • To inform the development of targeted adherence interventions.

Main Methods:

  • Qualitative study employing semi-structured interviews with 29 caregivers of children (≤12 years) within 2 years of HCT.
  • Demographic questionnaires collected alongside interviews.
  • Thematic analysis guided by grounded theory to identify key themes.

Main Results:

  • Four main categories of facilitators and strategies emerged: family, medication, caregiver, and multidisciplinary treatment team.
  • Caregivers demonstrated resourcefulness, independently developing numerous adherence strategies.
  • Identified facilitators and strategies varied among caregivers and evolved over time.

Conclusions:

  • Caregivers are resourceful but experience significant burden managing medications post-HCT.
  • Individualized, multicomponent support from the multidisciplinary team is crucial, especially after hospital discharge.
  • Further research should focus on developing and evaluating interventions to alleviate caregiver burden and improve adherence.
Abstract

Keywords:
caregiverhematopoietic stem cell transplantationmedication adherencepediatricsupport

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