Barriers in ensuring adherence to treatment in pediatric oncology: experience from a tertiary care center in a developing country

Background: Treatment adherence is a complex phenomenon, which has a significant impact on therapeutic success especially with respect to pediatric oncology patients in developing countries like ours where socioeconomic factors have an important bearing on treatment. To gain an insight into the factors that affect adherence in pediatric oncology we conducted this study in a tertiary care center. Methods: Retrospective analysis of case records of children <15 years of age who visited the pediatric Oncology out-patient department at Kidwai Cancer Institute between June -2018 and Jan-2019 was carried out to assess their adherence to treatment and in case of non-adherence to treatment the factors responsible were identified. Results: Of the 600 case records that were screened 115 of them had poor adherence to treatment. These patients were then studied in detail with respect to their demographic details and the factors responsible for poor adherence. The commonest causes for poor adherence that emerged from the study were those pertaining to socio-economic factors and caregiver issues. Conclusions: Socioeconomic factors and caregiver issues are important barriers to treatment adherence. Targeted interventions in the form of social support systems and shared care models have the potential to improve treatment adherence and consequently overall survival in developing countries