An App to Improve Medication Adherence for Young Patient and Family Caregiver Dyads

An App to Improve Medication Adherence for Young Patient and Family Caregiver Dyads

Dr. Sung Won Choi is developing a first-of-its kind just-in-time adaptive intervention (JITAI) that will target medication adherence in young patients and their family caregivers.

We seek to shift the current clinical paradigm by intervening in the dyad and exploring mechanisms by which dyads appraise the illness and engage in behaviors together.

Allogeneic HCT is among the most high-risk cancer procedures, with patients requiring consistent care and support, especially in the first 3-4 months post-procedure. The intense procedure, despite advancements, sees up to 50-70% of patients develop acute graft-versus host disease (GVHD), a leading cause of mortality. Medication non-adherence exacerbates the problem, with a staggering 67% of individuals reported to skip doses.

Funded by a d3center Pilot Grant, an optimized JITAI will provide personalized adherence support that addresses the dyadic unit as an interdependent team. Providing support at the right time, only when it is needed, JITAI can maximize engagement and minimize burden by delivering messages when there is really a benefit.

The dependence of adolescent and young adult patients on family caregivers, which often include a difference in power of authority, along with caregivers’ tendency to want to care and guide their patient through the illness continuum is unlike those seen in other dyadic relationships.

Key challenges are:

  • Optimally facilitating positive interactions in a setting that is inherently unbalanced and hierarchical, through a focus on shared goals, reciprocation, and positive emotions
  • Leveraging interactions to encourage and empower autonomy and independent agency

This project capitalizes on adolescent and young adult’s near ubiquitous use of technology and enables new directions in examining the link between physical and mental states, and how the young patient and caregiver might affect each other, individually and interdependently.

In the spirit of d3center research, this study moves beyond the “one-size-fits-all” approach, addressing the unique challenges and dynamics of the adolescent and young adult and caregiver dyad. Furthermore, it reflects the success of the Center’s open-source dissemination initiative: the original ADAPTS application is a modification of an app developed and released by Center investigators.

Principal Investigator

Sung Won Choi, MD
Michigan Medicine Pediatrics – Hematology Oncology

Key Collaborators

Susan A. Murphy, Harvard University
Inbal Billie Nahum-Shani, University of Michigan

Funding Source

Focus Area