Measuring medication adherence in pediatric cancer: An approach to validation

Jennifer M. Rohan; Tsuyoshi Fukuda; Melissa A. Alderfer; Crista Wetherington Donewar; Linda Ewing; Ernest R. Katz; Anna C. Muriel; Alexander A. Vinks; Dennis Drotar

doi:10.1093/jpepsy/jsw039

Measuring medication adherence in pediatric cancer: An approach to validation

Jennifer M. Rohan, Tsuyoshi Fukuda, Melissa A. Alderfer, Crista Wetherington Donewar, Linda Ewing, Ernest R. Katz, Anna C. Muriel, Alexander A. Vinks, Dennis Drotar

Psychiatry

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Objective This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP)medication adherence in amultisite cohort of pediatric patients diagnosed with cancer (N=139). Methods Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Results Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. Conclusions To our knowledge, thiswas the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric patients with cancer. Using multiple methods of adherencemeasurement could informclinical care and target patients in need of intervention.

Original language	English (US)
Pages (from-to)	232-244
Number of pages	13
Journal	Journal of pediatric psychology
Volume	42
Issue number	2
DOIs	https://doi.org/10.1093/jpepsy/jsw039
State	Published - 2017

Keywords

Adherence
Cancer
Metabolites
Metabolites
Pediatrics
Pharmacology

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health
Developmental and Educational Psychology

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10.1093/jpepsy/jsw039

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title = "Measuring medication adherence in pediatric cancer: An approach to validation",

abstract = "Objective This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP)medication adherence in amultisite cohort of pediatric patients diagnosed with cancer (N=139). Methods Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Results Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. Conclusions To our knowledge, thiswas the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric patients with cancer. Using multiple methods of adherencemeasurement could informclinical care and target patients in need of intervention.",

keywords = "Adherence, Cancer, Metabolites, Metabolites, Pediatrics, Pharmacology",

author = "Rohan, {Jennifer M.} and Tsuyoshi Fukuda and Alderfer, {Melissa A.} and Donewar, {Crista Wetherington} and Linda Ewing and Katz, {Ernest R.} and Muriel, {Anna C.} and Vinks, {Alexander A.} and Dennis Drotar",

note = "Funding Information: The work reported in this article was funded by the National Cancer Institute at the National Institutes of Health (grant numbers 1F31CA168307 to J.M.R., 1R01CA119162 to D.D.). This work was also supported by the National Center for Research Resources (grant number UL1RR024134 to M.A.) and the National Center for Advancing Translational Sciences (grant number UL1TR000003 to M.A.). Publisher Copyright: {\textcopyright} The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.",

year = "2017",

doi = "10.1093/jpepsy/jsw039",

language = "English (US)",

volume = "42",

pages = "232--244",

journal = "Journal of pediatric psychology",

issn = "0146-8693",

publisher = "Oxford University Press",

number = "2",

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T1 - Measuring medication adherence in pediatric cancer

T2 - An approach to validation

AU - Rohan, Jennifer M.

AU - Fukuda, Tsuyoshi

AU - Alderfer, Melissa A.

AU - Donewar, Crista Wetherington

AU - Ewing, Linda

AU - Katz, Ernest R.

AU - Muriel, Anna C.

AU - Vinks, Alexander A.

AU - Drotar, Dennis

N1 - Funding Information: The work reported in this article was funded by the National Cancer Institute at the National Institutes of Health (grant numbers 1F31CA168307 to J.M.R., 1R01CA119162 to D.D.). This work was also supported by the National Center for Research Resources (grant number UL1RR024134 to M.A.) and the National Center for Advancing Translational Sciences (grant number UL1TR000003 to M.A.). Publisher Copyright: © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved.

PY - 2017

Y1 - 2017

N2 - Objective This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP)medication adherence in amultisite cohort of pediatric patients diagnosed with cancer (N=139). Methods Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Results Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. Conclusions To our knowledge, thiswas the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric patients with cancer. Using multiple methods of adherencemeasurement could informclinical care and target patients in need of intervention.

AB - Objective This study described the prospective relationship between pharmacological and behavioral measures of 6-mercaptopurine (6MP)medication adherence in amultisite cohort of pediatric patients diagnosed with cancer (N=139). Methods Pharmacological measures (i.e., metabolite concentrations) assessed 6MP intake. Behavioral measures (e.g., electronic monitoring) described adherence patterns over time. Results Three metabolite profiles were identified across 15 months: one group demonstrated low levels of both metabolites (40.8%) consistent with nonadherence and/or suboptimal therapy; two other groups demonstrated metabolite clusters indicative of adequate adherence (59.2%). Those patients whose metabolite profile demonstrated low levels of both metabolites had consistently lower behavioral adherence rates. Conclusions To our knowledge, thiswas the first study to prospectively validate a pharmacological measure of medication adherence with a behavioral adherence measure in a relatively large sample of pediatric patients with cancer. Using multiple methods of adherencemeasurement could informclinical care and target patients in need of intervention.

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KW - Cancer

KW - Metabolites

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KW - Pharmacology

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Measuring medication adherence in pediatric cancer: An approach to validation

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