Compliance and adherence in pediatric oncohaematology

Introduction: Implementation of a therapeutic plan requires the doctor and the patient to work together. For adults, adherence involves a relationship between two people, whereas for paediatric patients it also involves the child’s parents. The behaviour of a parent and his or her beliefs about the therapy significantly affect the therapeutic process. The purpose of the study was to analyse the factors which affect the following therapeutic recommendations in paediatric oncohaematology.

Material and methods: The study covered 56 patients (37 in-patients and 19 out-patients). Fifty-one parents of children below 16 and five patients above 16 set out to complete the survey. The survey was an anonymous questionnaire prepared by the author.

Results: The causes of lack of adherence in the study group were: absent-mindedness (27%), high drug price (13%), dislike of the drug resulting from the form of its administration (enema, injections – 13%), concern about adverse effects of drugs (7%), improved health and well-being of the child (7%), emotional barrier (7%), and lack of confidence in the effectiveness of the prescribed drug (6%). Parents play an important role in the shaping of attitudes and behaviours related to a therapy. Parents with higher education have a greater awareness of the need to discuss the therapy with the child. Parents’ attitude to the child’s contact with the doctor changes with parents’ age. Information communicated to children where doctor-patient communications are via parents above 30 is restricted. Strict following of drug dosage recommendations is understood differently by the parents and the patients. The parents understand the strict following of recommendations as adherence, whereas with the patients compliance prevails.

Conclusions: Ongoing contact between the parents and the doctor, correct relationship between the doctor and the treated child, proper communication of therapeutic information, and simplification of the drug scheme may contribute to improved adherence and improved therapy outcome in paediatric oncohaematology.