What Are the Perceptions of Recipients of Allogeneic Hematopoietic Stem Cell Transplant about Medication Adherence?: A Synthesis of Qualitative Studies

Abstract

Background Recipients of allogeneic hematopoietic stem cell transplant (HSCT) may encounter difficulties in adhering to their post-transplant medication as prescribed to avoid complications. Despite the relevance of patients' perspectives to inform the clinical practice, to date, no summary regarding their lived experience of oral medication adherence (MA) has been produced. Objective To summarize the lived experience of MA by recipients of allogeneic HSCT as documented in qualitative studies. Methods A systematic review and meta-synthesis of qualitative research was performed. Six databases were searched up to June 27, 2023. Four qualitative studies met eligibility and were included: those designed and conducted with scientifically sound methodologies and those regarding adult patients who had undergone allogeneic HSCT and required an oral medication regimen in the post-transplant phase. Data were extracted and synthesized using thematic analysis. Results Four analytical themes were identified: "The initiation is a challenge,""Time as a new issue,""Internal and external obstacles threaten medication adherence,"and "Different strategies are the answer to medication non-adherence."Conclusions Medication adherence in patients after HSCT is a complex phenomenon wherein different factors play a role. When designing targeted interventions to improve MA, it is imperative to start with patients' experiences and perspectives. Implications for Practice Patients developed different strategies to deal with obstacles to MA that may inform daily practice. Before discharge, healthcare professionals should emphasize to both patients and carers the importance of MA.