Abstract B043: The MedSupport multilevel intervention to improve pediatric medication adherence: Results from a pilot study
Authors: Kelly Kara , Vincent Paula , Patel Hital , Kahn Justine , Bona Kira , Tran Thai Hoa , Rodriguez Elisa , Attwood Kristopher , Bouchard Elizabeth 
Published: September 2024

Abstract
Introduction: Nonadherence to oral chemotherapy is a well-documented problem in pediatric oncology. Medical innovations have dramatically increased the range of treatment that can be administered at home, increasing the responsibility placed on families in contributing to pediatric cancer outcomes. Yet, caregivers experience numerous barriers to adherence. Using the Health Belief Model, we developed MedSupport, a multi-level medication adherence that is designed to address root barriers to medication adherence. Design, Setting, Participants, and Measures: The MedSupport intervention was developed in collaboration with Pediatric Cancer Caregiver and Healthcare Provider Advisory Boards and includes three components. (1) Universal screening for adherence barriers (2) Tailored virtual education enhancement and (3) Communication of barriers to activate multidisciplinary healthcare teams. To assess feasibility and acceptability of the intervention following Bowen’s model, we recruited caregivers of pediatric acute lymphoblastic leukemia (ALL) patients ages 1 to 18 on oral home-based chemotherapy. All eligible families receiving outpatient-based chemotherapy at Roswell Park during April and May 2023 were approached for participation. Multidisciplinary healthcare providers who were on the care teams of enrolled patients were invited to participate. Acceptability among caregivers and healthcare providers was assessed using standardized measures aligned with the Implementation Outcomes Framework. Results: We implemented a pilot study of the MedSupport intervention at Roswell Park and we successfully implemented all study procedures. We demonstrated feasibility through: (1) Demand: 100% of eligible caregivers (N = 6) and healthcare providers (N = 8) approached agreed to participate. (2) Practicality: 100% of families completed the barriers screening questionnaire on the first prompt.All families endorsed adherence barriers (Range: 3-14). Families received between 2 and 6 educational videos based upon barriers endorsed. All families rated the length of videos as “just right.” Sending barrier alerts to healthcare providers was feasible, and we did not encounter any technical problems sending barrier alerts. (3) Acceptability: Caregivers rated the intervention as acceptable (Mean: 4.92), appropriate (Mean: 4.71), and feasible (Mean: 5). Healthcare providers rated the intervention as acceptable (Mean: 4.68), appropriate (Mean: 4.61), and feasible (Mean: 4.68). In qualitative feedback providers described the intervention as low burden and clinically helpful. Conclusions and Relevance: The MedSupport intervention is an innovative, low-cost, and scalable intervention to enhance home-based medication adherence in pediatric ALL that has potential for translation to clinical practice.
Citation Format: Kara Kelly, Paula Vincent, Hital Patel, Justine Kahn, Kira Bona, Thai Hoa Tran, Elisa Rodriguez, Kristopher Attwood, Elizabeth Bouchard. The MedSupport multilevel intervention to improve pediatric medication adherence: Results from a pilot study [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr B043.