Abstract

In pediatric cancer care, medication non-adherence is a significant driver of avoidable suffering and death. There is a lack of interventions designed for families of young children, where patient medication refusal/avoidance is a common barrier to adherence. We developed the CareMeds intervention which focuses on caregiver skills training to help young children take medicine calmly and without use of restraint techniques. The goal of this preliminary study was to assess the acceptability and feasibility of the CareMeds intervention. Caregivers of pediatric cancer patients (ages 2–10) whose children were on a home-based oral medication regimen were recruited to participate. Feasibility was examined through study enrollment and retention rates as well as reasons for refusal and drop out. Acceptability was evaluated through usability of and engagement with intervention components and an acceptability questionnaire. Feasibility: We recruited N = 9 caregivers to participate in this intervention pilot study and had a 75% enrollment rate. Reasons for declining included scheduling concerns (n = 2) and lack of interest (n = 1). The participant retention rate was 100% with 100% adherence to intervention sessions. Acceptability: Parents rated the sessions and resource materials as acceptable and reported frequent use of skills taught in the intervention. The CareMeds intervention is an acceptable and feasible strategy for caregivers of pediatric cancer patients and warrants future research to examine the efficacy of behavioral parenting skills interventions to improve medication adherence in young children.

摘要

在儿科癌症护理中，不遵守药物治疗是导致可避免的痛苦和死亡的重要因素。缺乏针对幼儿家庭设计的干预措施，患者拒绝/避免用药是依从性的常见障碍。我们开发了CareMeds干预措施，重点关注护理人员技能培训，帮助幼儿平静地服药，而不使用约束技术。这项初步研究的目的是评估CareMeds干预措施的可接受性和可行性。招募儿童癌症患者（2-10 岁）的护理人员参与其中，这些患者的孩子正在接受家庭口服药物治疗。通过研究入学率和保留率以及拒绝和退出的原因来审查可行性。通过干预措施的可用性和参与度以及可接受性调查问卷来评估可接受性。可行性：我们招募了 N = 9 名护理人员参与这项干预试点研究，入组率为 75%。拒绝的原因包括日程安排问题 ( n  = 2) 和缺乏兴趣 ( n  = 1)。参与者保留率为 100%，干预课程的遵守率为 100%。可接受性：家长将课程和资源材料评为可接受，并报告经常使用干预中教授的技能。CareMeds干预对于儿科癌症患者的护理人员来说是一种可接受且可行的策略，并值得未来研究来检验行为养育技能干预措施对提高幼儿用药依从性的有效性。