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Fostering Patient-Family Caregiver Teamwork in Self-Management of the Medical Regimen After Hematopoietic Cell Transplantation
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Fostering Patient-Family Caregiver Teamwork in Self-Management of the Medical Regimen After Hematopoietic Cell Transplantation

Donna M Posluszny, Dana H Bovbjerg, Arthur M Nezu, Karen L Syrjala, Lindsay Sabik, Susan M. Sereika, Mounzer Agha and Mary Amanda Dew
Psycho-oncology (Chichester, England), v 35(Suppl 1), e70380
01 Mar 2026
DOI: https://doi.org/10.1002/pon.70380
PMID: 41817456

Abstract

Biomedical Social Sciences Oncology Psychology
Background/Purpose: After hospital discharge post-HCT, patients and their family caregivers (FCGs) must adhere to a complex, multicomponent medical regimen, including multiple medications, port care, and lifestyle behaviors and restrictions. Successful regimen management, and potentially improved clinical outcomes, depends on how well patients and FCGs work as a team. Evidence-based interventions that focus equally on both the patient and FCG are urgently needed. We developed and have initiated testing of a novel 4-session patient-FCG dyadic problem-solving therapy (DPST), targeting regimen adherence, and delivered via video conference to maximize potential scalability and implementation. Methods: To optimize video-delivered DPST and increase feasibility, acceptability, efficacy, and eventual dissemination, we implemented a user-centered design approach for development and testing. We initially adapted our DPST from traditional PST for application to dyads and to the issue of medical adherence. We then completed stages of iterative development: (a) Stage 1, focus groups of patients, FCGs, and health care professionals to give feedback on DPST content and procedures; (b) Stage 2, piloting the refined intervention with dyads and seeking additional feedback; (c) Stage 3, evaluating the resulting 4-session DPST intervention in a single-site randomized controlled trial for acceptability, feasibility, and potential efficacy. Teamwork-related outcomes include medical regimen adherence, patient and FCG perceptions of task self-efficacy, and dyadic division of task responsibility. Results: For Stage 1, we conducted 3 patient focus groups (n = 12), 3 FCG groups (n = 12), and 3 health care professional groups (n = 14). The groups supported the dyadic teamwork approach, the focus on adherence, and use of video conferencing. Their suggested procedural changes (e.g., more flexible scheduling) were implemented in Stage 2, in which 3 dyads received the modified intervention and suggested further changes. Stage 3, now underway, is comparing the finalized DPST intervention to an attention-control study arm. Conclusions and Implications: Our developmental work suggests the potential for a novel patient-FCG team-based intervention to improve medical regimen adherence after HCT. This work capitalizes on the combined efforts of the patient and FCG to potentially improve clinical outcomes. If effective, the video conference delivery of DPST offers the potential for wide implementation and scalability.

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