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Updated: May 20, 2025

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Adherence unveiled: A concept analysis of medication adherence in adult patients with sickle cell disease
1University of South Florida, College of Nursing, Tampa, Florida.
Background:
Patients with sickle cell disease (SCD) require lifelong adherence to treatment protocols, significantly affecting their care quality. Despite effective disease-modifying drug therapies (DMDTs), adherence remains suboptimal, with 30%-60% of patients being nonadherent. Ensuring medication adherence is crucial to attain the intended outcomes of DMDTs in patients with SCD.
Purpose:
This article examines the concept of "medication adherence" in adult patients with SCD undergoing DMDTs, offering fresh insights, knowledge, and clarity regarding the concept.
Methodology:
Walker and Avant's methods for concept analysis were employed to establish attributes, antecedents, consequences, and empirical referents of adherence in adult patients with SCD on DMDTs. A thorough literature search of PubMed, Cochrane Library, and CINAHL was conducted, encompassing peer-reviewed articles published in English from 2009 to 2023, using keywords and Boolean operators pertinent to adherence and SCD.
Results:
Following the literature search, 55 articles were identified, with 29 excluded based on title and abstract. The eligibility process narrowed the count to 15 pertinent articles included in this concept analysis. Attributes, antecedents, and consequences were synthesized to formulate a definition well-founded in the literature.
Conclusions:
Adherence is crucial in health care and offers an opportunity for interventions to improve patient outcomes. Understanding adherence to treatment protocols is vital for health care providers and researchers, and it should be further integrated into research and practice to improve the quality of life for patients with SCD.
Implications:
Integrating SCD medication adherence into nursing education and continuing education has the potential to enhance clinical interventions, improve patient outcomes, and refine nursing practice.
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