Abstract
Although neurocognitive impairment has been established as a major issue among cancer survivors, the real-world consequences of this impairment are unclear. This study investigated the relationship between neurocognitive functioning and medication management ability over time among 58 patients treated with allogeneic hematopoietic stem cell transplantation (HCT). Participants completed a neuropsychological test battery and a simulated medication management task at three time points: pre-transplant (T0), Day 100 (T1) and 6 months post transplant (T2). Neurocognitively impaired participants performed worse on the medication management task than neurocognitively normal participants at each time point, and were more likely to score in the impaired range of medication management ability post transplant (72% vs 20%, P<0.001 at T1; 67% vs 23%, P=0.013 at T2). In multivariate analyses, worse performance in executive functioning/working memory consistently predicted impaired medication management ability, even when controlling for sociodemographic and clinical confounders (odds ratio=0.89, 95% confidence interval (0.80, 0.98), P=0.023). Lower physical symptom distress also predicted impaired medication management ability, but this effect decreased over time. Self-reported cognitive problems were not correlated with medication management ability at any time point. Findings suggest that poor neurocognitive functioning, particularly in the domain of executive functioning/working memory, is associated with worse medication management ability within the first 6 months after allogeneic HCT.
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Acknowledgements
Fred Banting and Charles Best Canada Graduate Scholarship – Doctoral Award, Canadian Institutes of Health Research; Rosenstadt Dissertation Award and Lawrence S. Bloomberg Faculty of Nursing were the research support. This manuscript contains original material previously presented at the annual scientific meeting of the Canadian Bone and Marrow Transplant Group in June 2014. The views expressed in this article are those of the authors and not an official position of the institution or the funders.
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Mayo, S., Messner, H., Rourke, S. et al. Relationship between neurocognitive functioning and medication management ability over the first 6 months following allogeneic stem cell transplantation. Bone Marrow Transplant 51, 841–847 (2016). https://doi.org/10.1038/bmt.2016.2
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DOI: https://doi.org/10.1038/bmt.2016.2