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Adherence to 6-Mercaptopurine in children and adolescents with Acute Lymphoblastic Leukemia

Alsous, M; Abu Farha, R; Alefishat, E; Al Omar, S; Momani, D; Gharabli, A; McElnay, J; ... Rihani, R; + view all (2017) Adherence to 6-Mercaptopurine in children and adolescents with Acute Lymphoblastic Leukemia. PLOS ONE , 12 (9) , Article e0183119. 10.1371/journal.pone.0183119. Green open access

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Abstract

OBJECTIVE: Studies on children with Acute Lymphoblastic Leukemia (ALL) reported non-adherence in 2–54% of cases. The primary objective of this study was to assess rates of adherence to 6-MP using two different methods in children and adolescents with ALL. Secondary aim was to identify factors that influence adherence to 6-MP in children with ALL. METHODS: All eligible children with ALL who are (≤ 19) years old and receive 6-MP therapy for at least 1 month were approached to participate in the study. A total of 52 children with ALL and their primary caregivers were recruited. Adherence measures included an objective method (measuring 6-MP metabolites in packed Red Blood Cells (RBCs)) and a subjective method (using parent and child self-report via the Medication Adherence Report Scale; MARS; Adherence was defined as 90% or greater). RESULTS: Rates of adherence varied across the measurement methods. Packed RBCs sample analysis indicated forty-four patients (84.6%) to be adherent. Using the MARS questionnaires, a total of 49 children (94.2%) were classified as being adherent according to the parental MARS questionnaire scores, while all the 15 children (100%) who answered the MARS (child) questionnaire were classified as adherent. Overall adherence rate was 80.8% within the studied population. CONCLUSION: MARS scale was shown to overestimate adherence compared to measurement of 6-MP metabolites in the blood. A combination of both methods led to increased detection of non-adherence to thiopurine in children with ALL.

Type: Article
Title: Adherence to 6-Mercaptopurine in children and adolescents with Acute Lymphoblastic Leukemia
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0183119
Publisher version: http://doi.org/10.1371/journal.pone.0183119
Language: English
Additional information: © 2017 Alsous et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology, Multidisciplinary Sciences, Science & Technology - Other Topics, INFLAMMATORY-BOWEL-DISEASE, SELF-REPORT, MEDICATION ADHERENCE, MAINTENANCE THERAPY, DRUG-THERAPY, CHILDHOOD, MERCAPTOPURINE, ISSUES, AZATHIOPRINE, RELAPSE
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: http://discovery.ucl.ac.uk/id/eprint/10024269
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