Research and Scholarship

Understanding Barriers to Oral Therapy Adherence in Adults With Acute Myeloid Leukemia

Ashley Leak Bryant,(1) PhD, RN-BC, OCN®, Ya-Ning Chan,(1) MSN, RN, Jaime Richardson,(1) BSN, RN, OCN®, CCRP, Matthew Foster,(1) MD, Susie Owenby,(2) BSN, RN, and Debra Wujcik,(2) PhD, RN

From (1)The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; (2)Carevive Systems, Inc., North Miami, Florida

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Ashley Leak Bryant, PhD, RN-BC, OCN®, Carrington Hall, Chapel Hill, NC 27599. Email: ashley_bryant@unc.edu

ABSTRACT

Acute myeloid leukemia (AML) is a disease of older adults, with a median age at diagnosis of 68 years. The availability of oral anticancer medications has increased, although the standard treatment for AML remains in intravenous form. We aim to identify barriers to adherence to oral medications in patients with AML and proposed solutions for improvements. Following institutional review board approval, patients with AML and their caregivers were recruited to participate in focus groups. Sessions were digitally recorded, transcribed verbatim, and analyzed for thematic content using Dedoose qualitative software. 11 patients (five < 65 years; six ≥ 65 years) and 4 caregivers participated in these sessions. Three central themes emerged: 1) medication adherence challenges, 2) managing an oral adherence plan, and 3) strategies to improve oral adherence. Participants recommended written schedules, taking medications around meals, and using pillboxes and alarms. We believe that patients are an important source of insight into barriers and solutions to oral medication adherence.

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