When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer
Abstract
:1. Introduction: Importance of Using Novel Objective Measures of Medication Adherence
2. Comparison of Two Objective Measures of Medication Adherence: An Illustration in Pediatric Cancer Using Behavioral Adherence (EM) and Pharmacological Assays
2.1. Behavioral Adherence Data Was Captured through Electronic Monitoring of 6MP Adherence Across 15-Months Using the Medication Event Monitoring System (MEMS®) from the AARDEX Corporation, Palo Alto, CA
2.2. Pharmacological Measures of 6MP Adherence Were Measured Using Metabolite Levels of 6MP
3. Conclusion: Importance of Using Multiple Objective Measures of Medication Adherence
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Cohort Demographics | ≥95% Beh Adh/Lo–Lo Met Grp (n = 111) | <95% Beh Adh/Adh Met Grp (n = 80) |
---|---|---|
Patient age at baseline (years), M ± SD | 12.36 ± 3.34 | 12.32 ± 3.65 |
Average 6MP Behavioral Adherence (5-day), M ± SD | 100.00 ± 0.00 | 50 ± 30.52 |
6MP Metabolite Levels, Absolute Values | ||
TGN (Absolute Value), M ± SD | 446.34 ± 189.51 | 708.37 ± 415.81 |
MMP (Absolute Value), M ± SD | 7029.48 ± 5092.65 | 23,748.94 ± 12,819.77 |
Duration of Cancer Diagnosis at Baseline (Years), M ± SD | 1.33 ± 0.35 | 1.24 ± 0.34 |
Duration of Maintenance Treatment at Baseline (Months), M ± SD | 17.58 ±10.30 | 14.61 ± 9.91 |
Child’s Gender, n (%) | ||
Male | 74 (66.7) | 52 (65) |
Female | 37 (33.3) | 28 (35) |
Child’s Ethnicity/Race, n (%) | ||
Non-Hispanic, Caucasian | 67 (60.4) | 41 (51.3) |
Non-Hispanic, Minority | 17 (15.3) | 10 (12.5) |
Hispanic | 27 (24.3) | 29 (36.3) |
Household Composition, n (%) | ||
One-caregiver household | 26 (23.4) | 28 (35) |
wo-caregiver household | 85 (76.6) | 52 (65) |
Total Annual Household Income (Before Taxes), n (%) | ||
<$18,745 | 19 (17.3) | 18 (23.4) |
$18,745–$32,874 | 15 (13.6) | 18 (23.4) |
$32,875–$48,999 | 13 (11.8) | 7 (9.1) |
$49,000–$72,999 | 18 (16.4) | 9 (11.7) |
$73,000–$126,500 | 26 (23.6) | 20 (26.0) |
>$126,000 | 19 (17.3) | 5 (6.5) |
Possibility of Different Medication Administration Method Used | ||
No | 80 (72.1) | 46 (57.5) |
Yes | 31 (27.9) | 34 (42.5) |
6MP Dose Recommendations | ||
Prescribed 6MP Dose Within/Above Dose Recommendations | 98 (88.3) | 79 (98.8) |
Prescribed 6MP Dose Below Dose Recommendations | 13 (11.7) | 1 (1.3) |
TPMT Genotype | ||
Heterozygote | 12 (11.8) | 10 (12.5) |
Wild type | 90 (88.2) | 70 (87.5) |
Patient Relapsed | ||
No | 103 (94.5) | 74 (94.9) |
Yes | 3 (5.5) | 4 (5.1) |
Patient Deceased | ||
No | 109 (100) | 77 (98.7) |
Yes | 0 (0) | 1 (1.3) |
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Cain, C.J.; Meisman, A.R.; Drucker, K.; Isaac, E.I.; Verma, T.; Griffin, J.; Rohan, J.M. When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer. Int. J. Environ. Res. Public Health 2020, 17, 1956. https://doi.org/10.3390/ijerph17061956
Cain CJ, Meisman AR, Drucker K, Isaac EI, Verma T, Griffin J, Rohan JM. When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer. International Journal of Environmental Research and Public Health. 2020; 17(6):1956. https://doi.org/10.3390/ijerph17061956
Chicago/Turabian StyleCain, Caitlin J., Andrea R. Meisman, Kirstin Drucker, Evrosina I. Isaac, Tanvi Verma, Jordyn Griffin, and Jennifer M. Rohan. 2020. "When Multiple Objective Measures of Medication Adherence Indicate Incongruent Adherence Results: An Example with Pediatric Cancer" International Journal of Environmental Research and Public Health 17, no. 6: 1956. https://doi.org/10.3390/ijerph17061956