Online Program

Factors Associated with Hematopoietic Stem Cell Transplant Survivors' Adherence to Medical Recommendations

Tuesday, November 3, 2015

Marjorie Margolis, B.A., School of Public Health/Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
Jane Austin, PhD, Department of Psychology, William Paterson University, Wayne, NJ
Lisa Wu, PhD, Oncological Sciences, Mount Sinai Hospital, New York, NY
Heiddis Valdimarsdottir, PhD, University of Iceland, Reykjavik, Reykjavik, Iceland
Christine Rini, PhD, UNC Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC
Introduction: Hematopoietic Stem Cell Transplant, a toxic but often lifesaving cancer treatment, puts patients at risk for life-threatening complications.  To reduce these risks, transplant survivors must take medications and change their lifestyle and environment (e.g., avoiding certain foods).   Little is known about their adherence to recommendations.  Furthermore, although sociodemographic factors such as income, race/ethnicity, and education are associated with lower medication adherence in other populations, it is unknown whether these factors are associated with lower adherence in transplant survivors. Methods: As part of a larger study, 315 transplant survivors 9 months to 3 years post-transplant reported whether their physician currently recommended dietary changes, changes to their adult home environment, changes to their social life, and medication therapy, then they reported the extent of their adherence on a 5-point Likert scale and completed measures of sociodemographics, health literacy, and financial strain.  Results: 46% (n=147) of survivors reported receiving at least one recommendation. Of these survivors, 51.7% (n=76) reported less than complete adherence (< 5) and 12.9% (n=19) reported moderate adherence (<3).  Correlational analysis revealed that education was positively associated with adherence (r=0.298, p<0.001). Although income was not correlated with adherence, survivors with greater financial strain reported lower adherence (r=-0.184, p=0.028). Variables not associated with adherence included: race/ethnicity, marital status, and health literacy. Conclusion: Self-reported adherence was relatively high in our sample of transplant survivors.  However, financial strain and education—variables related to health disparities—were associated with lower adherence and warrant future investigation to understand potential disparities in post-transplant adherence.

Learning Areas:

Assessment of individual and community needs for health education
Social and behavioral sciences

Learning Objectives:
Describe sociodemographic variables associated with adherence to medical team recommendations in hematopoietic stem cell transplant survivors.

Keyword(s): Cancer, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a doctoral student researching and conducting analysis in survivorship issues for hematopoietic stem cell transplant survivors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.