Suggestions for interventions by adherence category
| Components of adherence . | Strategies for addressing nonadherence . | ||
|---|---|---|---|
| Intentional . | Unintentional . | ||
| Initiation | Decides not to start | • Open provider-patient discussions about potential adverse effects of hydroxyurea, history, efficacy, and pros and cons compared with other treatments, including discussions about the potential effects of having untreated SCD. | • Educate non-hematologists about hydroxyurea indications for SCD. |
| • Have informal Q & A sessions with peers who are currently taking hydroxyurea. | • Open provider-caregiver discussions about hydroxyurea’s benefits, risks, and limitations and how these will be monitored while receiving treatment. | ||
| • Explore personal concerns and beliefs to help alleviate general aversion or fear of medication. | • For pediatric patients whose caregivers are considering hydroxyurea, hold informal Q & A sessions with other caregivers who opted to have their child take hydroxyurea. | ||
| • Respect the final decision of the individual and be open to future discussions. | |||
| Implementation | Adherence while taking | • Involve patient in reviewing laboratory results and changes to results as they start taking hydroxyurea. | • Provide tools to help prompt individuals when to take their medication (eg, phone app, incorporation into daily routine). |
| • Continue open and ongoing provider-patient conversations about concerns, worries, or perceived effects resulting from taking hydroxyurea. | • Open provider-patient/caregiver discussions about adherence challenges and potential strategies to addressing barriers. Use strength- based approaches to build on patient’s strengths to overcome adherence challenges. | ||
| • Collaborate with patients to identify ways to address barriers as they arise; use strength-based approaches to build on patient’s strengths to overcome adherence challenges. | • Continue routine discussions about any experienced adverse effects or concerns about the impact of taking hydroxyurea on the patient. | ||
| • Acknowledge and respect the challenges in maintaining a daily medication regimen. | |||
| Discontinuation | Decision to discontinue taking | • Have open discussion with patient/caregiver on factors leading to this decision. | • Have open discussion with patients and caregivers on factors leading to this decision and what it means for future opportunities and treatment modalities. |
| • Provide options for patients to continue hydroxyurea in the future. | |||
| • Respect the final decision of the individual and be open to future discussions. | |||
| Components of adherence . | Strategies for addressing nonadherence . | ||
|---|---|---|---|
| Intentional . | Unintentional . | ||
| Initiation | Decides not to start | • Open provider-patient discussions about potential adverse effects of hydroxyurea, history, efficacy, and pros and cons compared with other treatments, including discussions about the potential effects of having untreated SCD. | • Educate non-hematologists about hydroxyurea indications for SCD. |
| • Have informal Q & A sessions with peers who are currently taking hydroxyurea. | • Open provider-caregiver discussions about hydroxyurea’s benefits, risks, and limitations and how these will be monitored while receiving treatment. | ||
| • Explore personal concerns and beliefs to help alleviate general aversion or fear of medication. | • For pediatric patients whose caregivers are considering hydroxyurea, hold informal Q & A sessions with other caregivers who opted to have their child take hydroxyurea. | ||
| • Respect the final decision of the individual and be open to future discussions. | |||
| Implementation | Adherence while taking | • Involve patient in reviewing laboratory results and changes to results as they start taking hydroxyurea. | • Provide tools to help prompt individuals when to take their medication (eg, phone app, incorporation into daily routine). |
| • Continue open and ongoing provider-patient conversations about concerns, worries, or perceived effects resulting from taking hydroxyurea. | • Open provider-patient/caregiver discussions about adherence challenges and potential strategies to addressing barriers. Use strength- based approaches to build on patient’s strengths to overcome adherence challenges. | ||
| • Collaborate with patients to identify ways to address barriers as they arise; use strength-based approaches to build on patient’s strengths to overcome adherence challenges. | • Continue routine discussions about any experienced adverse effects or concerns about the impact of taking hydroxyurea on the patient. | ||
| • Acknowledge and respect the challenges in maintaining a daily medication regimen. | |||
| Discontinuation | Decision to discontinue taking | • Have open discussion with patient/caregiver on factors leading to this decision. | • Have open discussion with patients and caregivers on factors leading to this decision and what it means for future opportunities and treatment modalities. |
| • Provide options for patients to continue hydroxyurea in the future. | |||
| • Respect the final decision of the individual and be open to future discussions. | |||