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Medication nonadherence to immunosuppressants after adult allogeneic haematopoietic stem cell transplantation: a multicentre cross-sectional study

Bone Marrow Transplantation volume 52, pages 304–306 (2017)Cite this article

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Following allogeneic haematopoietic stem cell transplantation (HSCT), adherence to immunosuppressants (IS) is crucial to prevent and treat chronic GvHD (cGvHD), which is associated with reduced quality of life, increased morbidity and mortality, and increased overall health-care needs.1 According to Vrijens’2 taxonomy of medication nonadherence (MNA), it can be defined as a deviation from the prescribed medication regimen sufficient to adversely influence the regimen’s intended effect. This may involve late or non-initiation of the prescribed treatment, suboptimal implementation of the dosing regimen (taking; drug holidays; timing; dose reduction), early discontinuation of treatment or any combination of these.2 Although studies in the HSCT population are lacking, evidence in oral anti-tumour CML treatment shows alarming prevalences of up to 85.8%.3, 4

Identifying patients at risk of MNA and developing adherence-enhancing interventions for them demands an understanding of the underlying reasons for nonadherence. Therefore, the aims of this study were: (1) to describe the prevalence of different forms of MNA, (2) to examine associations between MNA and selected correlates and (3) to explore the association between immunosuppressive MNA and cGvHD.

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Acknowledgements

We sincerely thank the patients who participated in the PROVIVO study and shared their experiences with us. We also thank Chris Shultis and Sarah Jayne Liptrott for their editing work.

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Authors and Affiliations

  1. Department of Health, University of Applied Science St.Gallen, St.Gallen, Switzerland

    B Gresch

  2. Department of Anaesthesiology, University Hospital Basel, Basel, Switzerland

    M Kirsch

  3. Institute of Nursing Science, University of Basel, Basel, Switzerland

    K Fierz, K Denhaerynck & S De Geest

  4. Department of Haematology, University Hospital Basel, Basel, Switzerland

    J P Halter & G Nair

  5. Department of Public Health and Primary Care,

    S De Geest

  6. Academic Centre for Nursing and Midwifery,

    S De Geest

  7. KU Leuven, Leuven, Belgium

    S De Geest

Authors
  1. B Gresch
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  2. M Kirsch
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  3. K Fierz
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  4. J P Halter
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  5. G Nair
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  6. K Denhaerynck
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  7. S De Geest
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Correspondence to S De Geest.

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Gresch, B., Kirsch, M., Fierz, K. et al. Medication nonadherence to immunosuppressants after adult allogeneic haematopoietic stem cell transplantation: a multicentre cross-sectional study. Bone Marrow Transplant 52, 304–306 (2017). https://doi.org/10.1038/bmt.2016.262

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