Rethinking Adherence: A Proposal for a New Approach to Risk Assessment.

The term ‘‘adherence’’ broadly refers to the relationship between patient behaviors and the recommendations of the healthcare team. Among adolescent and young adult (AYA) oncology patients between the ages of 15 and 39 years, non-adherence is likely a factor in medical as well as psychosocial outcomes, both of which may be inferior among AYAs as compared to younger or older patients with cancer. However, few studies have analyzed the psychosocial aspects of AYA non-adherence, and current approaches to adherence risk assessment fail to address the unique developmental needs of AYA cancer patients. While new research strives to better define and measure adherence, clinicians may be able to optimize it by considering their patient’s level of maturity and independence, psychosocial challenges, and unmet needs. In this perspective, we propose a new platform for risk assessment that promotes adherence by individualizing interventions and enhancing collaboration between patients and providers. Ultimately, such an approach may improve outcomes in AYA patients with cancer.