Pediatric polypharmacy and children with medical complexity
neurological impairment
DISEASE
Pediatric polypharmacy(defined as concurrent use of ≥ 5 medications) is a major public health problem with high prevalence among the priority population of children with medical complexity (CMC) [While polypharmacy is often necessary for symptom and disease management in CMC, opportunities for improved outpatient medication management are ubiquitous [Numerous potential benefits of a systematic approach to MTM-like services in an analogous pediatric population have been described. In a study of 100 CMC with polypharmacy in the ambulatory setting, an average of 3.4 MRPs were identified per patient, with 97% of patients having opportunities for potential intervention [In the priority population of CMC, the additional administrative complexity of polypharmacy regimens may introduce further risks and opportunities for benefit of MTM services, particularly those focused on medication simplification where appropriate. In a study of 123 pediatric patients with neurological impairment and polypharmacy, patients’ medication regimens included a median of 31 total doses of medication, 6 unique dosage forms, 7 different dosing frequencies, and 5 medications with additional administration specifications (e.g., split/crush tablet, open capsule for administration via g-tube) per patient [