Supporting Adolescents and Young Adults with Medication Adherence during Cancer Treatment

By Alexandra Psihogios, PhD

When a child or adolescent/young adult (AYA) is diagnosed with cancer, they are often asked to take many different medications when at home. For example, they may be prescribed medications to treat cancer (i.e., oral chemotherapies), medications to help prevent infection, and/or medications to help alleviate side effects from treatment such as nausea.

Even with the best intentions, missing medications is incredibly common. This can be especially true for AYA, who may be learning how to be independent with medications for the first time or want their lives to be as normal and medication-free as possible. Other barriers to medication adherence can include forgetting, difficulties swallowing pills, not liking the taste of medications, undesirable medication side effects, family miscommunications, and issues with insurance or a pharmacy.

If you and your family are struggling with medication adherence during cancer treatment, you are not alone. The first step to getting help is to have an honest discussion with your CHOP oncology team about these challenges. They are here to listen and support you, not judge or criticize. The team at the Oncology Psychosocial Services Program, including child life specialists, social workers and psychologists, can help provide resources and strategies for promoting adherence.

Here are 10 evidence-based strategies for supporting AYA with medication adherence:

1. Keep the medication where you can see it, but safely out of reach of children (for example, in a pillbox pushed to the back of the kitchen counter).
2. Link the medications with another routine (like meals or brushing teeth).
3. Use visuals to help you remember (put a sign on the refrigerator or set the background of your smartphone to a picture of the medication).
4. Use technology to remind you (set an alarm, use a free medication management app, or have family or friends text you to remind you).
5. When you are not at home, prepare by carrying an extra dose of medication.
6. Set clear family roles about who is responsible for each medication.
7. For AYA who take medications on their own, check-ins from family and/or friends are useful for staying on track — this is a team sport.
8. Visualize the “big picture” of how medications are or will help you thrive — and remember that they are temporary.
9. Talk to your oncology team about any side effects from the medication.
10. Let your oncology team know if you are having difficulty accessing medications due to cost, an insurance issue or a pharmacy issue.

This program is made possible by funding from the Mattie Miracle Cancer Foundation.