Promoting Treatment Adherence in Childhood and Adolescent Cancer

Scientific evidence suggests that many adolescents with acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LBL) do not adhere to their prescribed medication regimens. Such nonadherence may have undesirable clinical and scientific consequences; not only can it increase the risk of relapse, but it can also reduce the validity of data for clinical trials of medication treatment.

To address the need for studies of efficacy of adherence promotion in pediatric cancer, we conducted a randomized clinical trial (RCT) with children and adolescents diagnosed with ALL / LBL to evaluate a family-centered, problem-solving intervention (FPST) to promote adherence to oral medication treatment.  This intervention was compared with current psychological care. The proposed study identified effective strategies to promote adherence among children and adolescents with ALL / LBL. Our findings may potentially lead to improved medical outcomes for these children and adolescents.

The proposed intervention model

The proposed intervention model is novel in that it integrates three key components derived from theory and research on pediatric illness and treatment adherence. The components are:

      1. Training in collaborative problem solving and effective parent-child / adolescent communication, intended to reduce barriers that interfere with adherence to oral medication treatment 

      2. Promotion of the child’s or adolescent's active participation in, and motivation for, the management of ALL / LBL therapy 

      3. Emphasis on parental support and child / adolescent adherence to treatment that is consistent with the developmental needs of the child or adolescent.

Current Progress

Recruitment for the study closed in January 2012 -- 139 patients and their families participated in the baseline data collection visit. Data collection for the study ended in 2014. The study investigators are currently in the process of analyzing data and preparing manuscripts for publication.