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Hematopoietic stem cell transplant (HSCT) is a treatment for pediatric patients with a wide range of serious immunological, hematological and oncological diagnoses. The first 6- to 7-months post-HSCT is a critical period during which children are most at risk for life-threatening infections and graft versus host disease (GVHD). To prevent these serious complications, an intense prophylactic oral medication regimen is prescribed. Non-adherence to this regimen results in suboptimal drug exposure increasing the patient’s risk of these post- transplant complications. Despite this, there are no rigorous scientific studies documenting the modifiable factors that predict non-adherence or how NA impacts HSCT outcomes.
The HOME study will identify factors influencing adherence in pediatric HSCT. Two hundred and fifty-four caregivers of children (ages ≤ 10 years) will be recruited and complete online questionnaires to assess factors expected to be associated with NA prior to the child’s discharge and at 1-, 3-, 5-, & 7-months post-discharge. The HOME study will provide the fundamental knowledge that is needed to develop time- and treatment-specific behavioral and systems-based adherence interventions that will optimize the delivery and efficacy of medical treatments.
FUNDING INFOMATON: Pending
TAKE-IT is a multi-site international study evaluating a clinic-based program to promote oral medication adherence in adolescent kidney transplant recipients. We will also examine the impact of the intervention on kidney function and graft outcomes, while identifying characteristics of healthcare systems that are independently associated with adherence and health outcomes in this population.
FUNDING INFORMATION: NIH R01
The CAPS study has two objectives: 1) to optimize patient adherence of adolescents and young adults (A/YA) with cancer by incorporating a collaborative adherence promotion intervention into routine clinical care, and 2) to increase medical provider knowledge regarding oral medication adherence monitoring and promotion for A/YA with cancer. Using quality improvement (QI) methodology (i.e., Plan, Do Study Act Cycles; PDSAs), a clinic-based adherence promotion intervention will be integrated into regular clinical visits for adolescents and young adults being treated for leukemia or lymphoma at CCHMC. This study will establish evidence-based standards of clinical care for adherence assessment and promotion in pediatric oncology.
FUNDING INFORMATION: OhioPACE
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