Current needs in pediatric pharmacoepidemiology

Abstract

Our needs assessment describes a preliminary picture of the emerging sub-specialty of pediatric pharmacoepidemiology encompassing a range of age sub-groups, disease areas, and medical specialties. The assessment also documents a body of methodologic challenges unique to pharmacoepidemiologic research in children. Copyright © 2016 John Wiley & Sons, Ltd.

In the Real-World, Kids Use Medications and Devices

“…Databases are de-identified by removing personal information, and birth date is often one of the first variables stripped from a record. This may not be a huge problem when studying adults or older children, but birth date is an essential variable when studying newborns, infants, and young children, where we wish to study events over days, weeks, or months [9]. Close behind month and date of birth in importance are variables such as birth weight and gestational age, which are sometimes available in an EHR but often missing from administrative or claims databases.…”

“…Another challenge unique to studying medications in children is that of linking information in the child’s record to that of the mother, father, or siblings [9]. This is desirable when attempting to include variables such as age, height, and weight of the mother and father, maternal medication exposure during pregnancy, or risk factors such as substance abuse, obesity, socio-economic status, and other conditions, all of which may affect medication exposure and children’s health outcomes and introduce potential confounding.…”

“…Researchers studying medications and devices in children are often concerned about outcomes such as days missed from school, promotion to the next grade level, behavior issues, and test performance, all of which can be ascertained through school records. It is highly desirable to link data about drug and device utilization with outcome variables such as school performance to describe the real-world benefits and risks associated with medications and devices used by children [9]. School performance is an outcome of interest when studying psychotropic medications, liver transplants, and other conditions, and it is possible that some researchers may find it of interest to also describe extra-curricular performance and participation [16, 17].…”