Discussion
Optimal health for the priority population of CMC often depends on the chronic use of multiple medications in the outpatient setting. In all populations, MRPs resulting from polypharmacy can lead to potentially devastating outcomes, and CMC are indeed more vulnerable to MRPs. For example, in a study of 144 million pediatric emergency department visits, CMC were approximately 5 times more likely to experience an ADE-related emergency visit [Real and potential limitations of the study do exist. First, enrollment plans were established in alignment with our prior medication safety studies, in which enrollment occurred at a rate of approximately 100 patient-parent pairs per year [The pMTM study is the first randomized controlled trial to evaluate a centralized, coordinated, and comprehensive approach to medication management in CMC with polypharmacy. The results of this trial will quantify the impact of the pMTM intervention on medication safety, effectiveness, and overall medication complexity. Additionally, this trial will examine the impact of pMTM on subsequent acute healthcare utilization by CMC. Through the described systematic approach, the results of this trial will inform the pediatric medical community on the value and effectiveness of pMTM towards optimization of medication therapy among CMC with polypharmacy.