Feasibility Trial of a Tailored Adherence-Promotion Intervention for Adolescents and Young Adults With Cancer

Adherence to cancer treatment protocol medications is critical for optimizing health outcomes, but up to 60% of adolescents and young adults (AYAs) with cancer miss doses. This randomized pilot trial evaluated the feasibility, usability, and acceptability of a tailored adherence-promotion intervention (Supporting Medication Management with Individualized Treatment, SUMMIT) for AYAs with cancer.

Seventy AYAs (ages 15-24 years) prescribed an oral chemotherapy or a prophylactic antimicrobial as part of their cancer treatment regimen enrolled in the trial. Of these, 24 met criteria for randomization and were assigned to the intervention (SUMMIT) or control (uniform standard of care) arm. Feasibility data were tracked prospectively. AYAs completed usability and acceptability measures and stored their medication in an electronic adherence monitoring device. Descriptive statistics were used to evaluate achievement of feasibility thresholds. An analysis of covariance (ANCOVA) and a logistic regression were used to explore group differences in electronically monitored adherence.

Enrollment (70/77 = 91%), retention (56/65 = 86%), fidelity (100%), and assessment completion (100%) rates exceeded thresholds. The intervention was rated as usable and acceptable. Compared to those randomized to the control arm, AYAs randomized to SUMMIT had 18% higher post-intervention adherence (95% confidence interval [CI] = 3.56, 32.35) and were 12 times more likely to improve their adherence by 10% or more from pre- to post-intervention (odds ratio = 12.00, 95% CI = 1.51, 95.53).

Feasibility, acceptability, and usability data are promising, and results suggest this tailored adherence-promotion intervention has the potential to increase medication adherence among AYAs with cancer.

ClinicalTrials.gov Registration: NCT05706610.