Evidence map›Paper›PMID 25404717›Full record

SynthesisPediatrics2014

Medication adherence among pediatric patients with sickle cell disease: a systematic review.

Kathleen E Walsh, Sarah L Cutrona, Patricia L Kavanagh, Lori E Crosby, Chris Malone, Katie Lobner, David G Bundy

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Pediatrics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 7 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kathleen E WalshDepartment of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati School of Medicine, Cincinnati, Ohio; Departments of Pediatrics, and Meyers Primary Care Institute, Worcester, Massachusetts; Kathleen.walsh@cchmc.org.
Sarah L CutronaMeyers Primary Care Institute, Worcester, Massachusetts; Medicine, University of Massachusetts, Worcester, Massachusetts;
Patricia L KavanaghDepartment of Pediatrics, Boston University, Boston, Massachusetts;
Lori E CrosbyDepartment of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati School of Medicine, Cincinnati, Ohio;
Chris MaloneMeyers Primary Care Institute, Worcester, Massachusetts;
Katie LobnerWelch Medical Library, Johns Hopkins Medical Center, Baltimore, Maryland; and.
David G BundyDepartment of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.

Funding

University of Massachusetts Center for Clinical and Translational ScienceKL2TR000160 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LUZURIAGA, KATHERINE F · 2012 to 2014
$1.7M
Patient-Provider Interventions to Improve Transition to Adult Care in SCDK07HL108720 · NHLBI · CINCINNATI CHILDRENS HOSP MED CTR · PI CROSBY, LORI E · 2011 to 2014
$1.6M
NCATS NIH HHS KL2 TR000160NCATS NIH HHS KL2TR000160NHLBI NIH HHS 1K07HL108720-03NHLBI NIH HHS K07 HL108720
6 · The paper itself

Abstract

objectivesDescribe rates of adherence for sickle cell disease (SCD) medications, identify patient and medication characteristics associated with nonadherence, and determine the effect of nonadherence and moderate adherence (defined as taking 60%-80% of doses) on clinical outcomes.

methodsIn February 2012 we systematically searched 6 databases for peer-reviewed articles published after 1940. We identified articles evaluating medication adherence among patients <25 years old with SCD. Two authors reviewed each article to determine whether it should be included. Two authors extracted data, including medication studied, adherence measures used, rates of adherence, and barriers to adherence.

resultsOf 24 articles in the final review, 23 focused on 1 medication type: antibiotic prophylaxis (13 articles), iron chelation (5 articles), or hydroxyurea (5 articles). Adherence rates ranged from 16% to 89%; most reported moderate adherence. Medication factors contributed to adherence. For example, prophylactic antibiotic adherence was better with intramuscular than oral administration. Barriers included fear of side effects, incorrect dosing, and forgetting. Nonadherence was associated with more vaso-occlusive crises and hospitalizations. The limited data available on moderate adherence to iron chelation and hydroxyurea indicates some clinical benefit.

conclusionsModerate adherence is typical among pediatric patients with SCD. Multicomponent interventions are needed to optimally deliver life-changing medications to these children and should include routine monitoring of adherence, support to prevent mistakes, and education to improve understanding of medication risks and benefits.

Indexed as

Antibiotic ProphylaxisAdolescentAnemia, Sickle CellChildDrug MonitoringDrug SubstitutionHumansHydroxyureaIron Chelating AgentsMedication AdherencePatient Education as TopicPenicillinsTreatment OutcomeYoung AdultHydroxyureaIron Chelating AgentsPenicillinsmedication adherencesickle cell disease

Identifiers

PMID25404717
PMCPMC4243064

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.