Medication discharge teaching in pediatric hematopoietic stem cell transplantation: teaching characteristics, caregiver perceptions, and postdischarge adherence

Abstract Background: Hematopoietic stem cell transplantation (HCT) is an arduous but necessary treatment for many otherwise incurable diseases. It involves a complex medication regimen that is linked to significant clinical outcomes and must be learned by families before discharge. The purpose of this study was to qualitatively explore medication discharge teaching factors and to examine associations between those factors and caregiver self-perceived knowledge and efficacy. Methods: Nineteen video-recorded medication discharge teachings, conducted by hematopoietic stem cell transplantation pharmacists, were coded to identify elements of discharge teaching, including information presented, communication, and environmental factors. Caregivers also completed a semistructured interview and a short measure to assess caregiver efficacy regarding their child's medication regimen. Results: Pharmacists were consistent in their review of the names, dosages, and frequency of the medications being prescribed. However, there was variability regarding information provided about adherence, specific learnings (ie, how to read/fill syringe), and behavioral strategies to promote adherence (ie, adjust timing to fit family's schedule). Immediately and 1 week after the teaching, caregivers reported high levels of confidence regarding their ability to understand and manage their child's medication regimen. Conclusion: Teaching families about the prescribed medication regimen is a critical component of the discharge process. The current findings suggest that increasing the consistency with which information is provided to families regarding the effective management of the medication regimen could potentially be a method to facilitate adherence.