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

Author

Listed:
  • Mervat Alsous
  • Rana Abu Farha
  • Eman Alefishat
  • Suha Al Omar
  • Deema Momani
  • Alia Gharabli
  • James McElnay
  • Robert Horne
  • Rawad Rihani

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.

Suggested Citation

  • Mervat Alsous & Rana Abu Farha & Eman Alefishat & Suha Al Omar & Deema Momani & Alia Gharabli & James McElnay & Robert Horne & Rawad Rihani, 2017. "Adherence to 6-Mercaptopurine in children and adolescents with Acute Lymphoblastic Leukemia," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-12, September.
    • Handle: RePEc:plo:pone00:0183119
    DOI: 10.1371/journal.pone.0183119
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