Abstract: TH-PO772
Current Practice and Resources for Medication Adherence Assessment Among Pediatric Kidney Transplant Programs
Session Information
- Pediatric CKD
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1700 Pediatric Nephrology
Authors
- Huda, Naureen, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
- Hooper, David K., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Pruette, Cozumel S., Johns Hopkins University, Baltimore, Maryland, United States
Background
Adolescent/young adult kidney transplant recipients have 3 times the risk of allograft failure compared to other age groups. This is multifactorial, but barriers to medication adherence are a major contributor, present in up to 40%. To inform future adherence interventions, we assessed current practice patterns and resources available to address barriers to medication adherence among US pediatric kidney transplant programs.
Methods
Kidney transplant team members, including physicians (MD/DO), nurse practitioners (NP), physician assistants (PA), social workers (SW), and pharmacists, from 22 kidney transplant programs in the Improving Renal Outcomes Collaborative were surveyed about institutional characteristics, resources and current practice assessing medication adherence. 64 unique surveys were included, with representation from 22/26 (85%) of IROC-affiliated institutions.
Results
All teams indicated they have at least one MD/DO, nutritionist, and SW, which form the core team. Additional roles of NP, PA, transplant nurse, pharmacist, psychologist, and child life specialist were available in only some institutions. Each of 10 common barriers to medication adherence was reported to be assessed by at least one provider type during routine clinic visits. The majority reported assessing barriers to adherence at every clinic visit. However, subjective assessment methods were most commonly used, including forming a clinical impression based on history/exam and indirect and direct questions (Figure).
Conclusion
Provider assessment of medication adherence for pediatric kidney transplant patients varies among practices. While centers report that it is frequently assessed, subjective measures, which may overestimate adherence, are used most commonly. There is opportunity to standardize adherence barriers assessment with standard surveys/tools and to use objective measures, such as pharmacy refill records, to more accurately assess adherence. Future studies are needed to improve assessment of adherence.
Funding
- Private Foundation Support