Nonadherence in adolescent oncology patients: Preliminary data on psychological risk factors and relationships to outcome

Published nonadherence rates in the adolescent oncology population range from 33 to 60% though little is known about the psychological factors that contribute to adherence and the relationship between outcome and nonadherence. Our study was designed to investigate psychological and family factors related to adherence and the relationship between adherence and survival in this population. We evaluated 44 ( 27 males, 17 females) patients with cancer (13-17 years) who were at least 6-months postdiagnosis. Adherence with trimethoprim/ sulfamethoxazole (TMP/SMX) was determined at one point in time, using serum assay. Twelve of the patients ( 27%) had no detectable TMP/SMX. Patients without detectable drug had higher levels of depression, lower self-esteem, and higher levels of parent-child incongruence. Survival rates, 6 years after the initiation of the study, were lower in the group of participants categorized as nonadherent. These findings, if confirmed, have implications for the management of nonadherence and mood in this population.