Polypharmacy in pediatric patients and opportunities for pharmacists' involvement

Abstract

Rates of chronic conditions among pediatrics have been steadily increasing and medications used to treat these conditions have also shown a proportional increase. Most clinical trials focus on the safety of solitary medications in adult patients. However, data from these trials are often times extrapolated for use in pediatric patients who have different pharmacokinetic processes and physical profiles. As research increases and more drugs become available for pediatric use, the issue of polypharmacy becomes more of a concern. Polypharmacy is defined as the practice of administering or using multiple medications concurrently for the treatment of one to several medical disorders. With the increased rates of diagnosed complex disease states as prescribed mediations in pediatric patients, the prevalence and effect of polypharmacy in this patient population is largely a mystery. Polypharmacy falls within the realm of expertise of specialized pharmacists who can undertake medication therapy management services, medical chart reviews, and other services in pediatrics. Pharmacists have the time and knowledge to undertake pertinent interventions when managing polypharmacy and can play a major positive role in preventing adverse events. The aim of this paper is to review the literature on pediatric polypharmacy and provide insight into opportunities for pharmacists to help with management of polypharmacy. Information on adverse events, efficacy, and long-term outcomes with regard to growth and development of children subject to polypharmacy has yet to be published, leaving this realm of patient safety ripe for research.

Variation of the prevalence of pediatric polypharmacy: A scoping review

“…Pediatric polypharmacy is the term used to describe children taking more than one medication . Literature has shown that the prevalence of polypharmacy is on the rise for both adults and chidren . While the full implications of polypharmacy are unknown, polypharmacy has been linked to an increase in adverse drug reactions, potential drug‐drug interactions, hospital readmissions, and medical costs .…”

“…1,2 Literature has shown that the prevalence of polypharmacy is on the rise for both adults and chidren. 3,4 While the full implications of polypharmacy are unknown, polypharmacy has been linked to an increase in adverse drug reactions, 5 potential drug-drug interactions, 6 hospital readmissions, 7 and medical costs. 8 The observed prevalence of pediatric polypharmacy depends on patient characteristics, contextual, and study design factors.…”

A transdisciplinary team approach to scoping reviews: the case of pediatric polypharmacy

“…Exposure to multiple medications is common among pediatric patients in both inpatient and outpatient settings [ 1 – 4 ]. Using multiple medications can have benefits such as augmentation, tolerability, and efficacy [ 5 – 7 ], or harms such as adverse drug reactions, drug-drug interactions, difficulty adhering to complex regimens, toxicity, overdose, and increased cost [ 8 – 12 ].…”

Polypharmacy in Pediatrics: Modern Conditions

“…Дети с тяжелыми хроническими заболеваниями, такими как астма, эпилепсия или муковисцидоз, получают несколько препаратов одновременно согласно существующим клиническим рекомендациям по ведению таких пациентов: например, пациентам с муковисцидозом могут назначаться панкреатические ферменты, поливитамины, антибиотики, противовоспалительные средства, бронхо-и муколитики [19]. Хотя эти пациенты будут получать комбинированную терапию практически постоянно, данные схемы лечения документируются соответствующим образом и отслеживаются для оптимального управления заболеванием [20].…”