The depth, duration, and degree of outpatient pediatric polypharmacy in Colorado fee-for-service Medicaid patients

Feinstein, James A.; Feudtner, Chris; Valuck, Robert J.; Kempe, Allison

doi:10.1002/pds.3843

Cited by 42 publications

(58 citation statements)

References 21 publications

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“…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 .…”

Section: Introductionmentioning

confidence: 99%

“…Pediatric polypharmacy is the term used to describe children taking more than one medication. 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.…”

Section: Introductionmentioning

confidence: 99%

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Variation of the prevalence of pediatric polypharmacy: A scoping review

Baker

Feinstein

et al. 2019

Pharmacoepidemiology and Drug

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Purpose To examine the range of prevalence of pediatric polypharmacy in literature through a scoping review, focusing on factors that contribute to its heterogeneity in order to improve the design and reporting of quality improvement, pharmacovigilance, and research studies. Methods We searched Ovid Medline, PubMed, EMBASE, CINAHL, Ovid PsycINFO, Cochrane CENTRAL, and Web of Science Core Collection databases for studies with concepts of children and polypharmacy, along with a hand search of the bibliographies of six reviews and 30 included studies. We extracted information regarding study design, disease conditions, and prevalence of polypharmacy. Results Two hundred eighty‐four studies reported prevalence of polypharmacy. They were more likely to be conducted in North America (37.7%), published after 2010 (44.4%), cross‐sectional (67.3%), in outpatient settings (59.5%). Prevalence ranged from 0.9% to 98.4%, median 39.7% (interquartile range [IQR] 22.0%‐54.0%). Studies from Asia reported the highest median prevalence of 45.4% (IQR 27.3%‐61.0%) while studies from North America reported the lowest median prevalence of 30.4% (IQR 14.7%‐50.2%). Prevalence decreased over time: median 45.6% before 2001, 38.1% during 2001 to 2010, and 34% during 2011 to 2017. Studies involving children under 12 years had a higher median prevalence (46.9%) than adolescent studies (33.7%). Inpatient setting studies had a higher median prevalence (50.3%) than studies in outpatient settings (38.8%). Community level samples, higher number and duration of medications defining polypharmacy, and psychotropic medications were associated with lower prevalence. Conclusions The prevalence of pediatric polypharmacy is high and variable. Studies reporting pediatric polypharmacy should account for context, design, polypharmacy definition, and medications evaluated.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Variation of the prevalence of pediatric polypharmacy: A scoping review

Baker

Feinstein

et al. 2019

Pharmacoepidemiology and Drug

Self Cite

View full text Add to dashboard Cite

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“…This difference in constipation frequency for tapentadol and/or oxycodone/naloxone found in our study might be explained because our study was performed in real world patients that were polymedicated with several opioids co‐prescribed presenting a high potential DDI. Present data showed that polypharmacy was common, being more frequent in the case group. It is important to note that when discussing “co‐prescribing” this does not necessarily mean that the prescriptions are coming from the same physician.…”

Section: Discussionmentioning

confidence: 53%

Health benefits of an adverse events reporting system for chronic pain patients using long‐term opioids

Planelles

Margarit

Ajo

et al. 2018

Acta Anaesthesiol Scand

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“…Overall, prescription drug use increased in many of the most common drug classes used by Americans including antihypertensives, antihyperlipidemics, antidepressants, antidiabetic agents, prescription analgesics, prescription proton-pump inhibitors, anticonvulsants, bronchodialators, and muscle relaxants [6]. Outpatient pediatric (aged ≤ 18) polypharmacy is also substantial with a prevalence rate of 10%, occurring more often in the setting of a complex chronic condition [9]. Individuals greater than 65 years old are the biggest consumers of medications; however, evidence shows that greater than 50% of elderly patients are taking at least one medication that is not medically necessary [10].…”

Section: Drug Prescription Practicesmentioning

confidence: 99%

Dangers of Polypharmacy

Valenza¹,

McGinley²,

Feldman³

et al. 2017

Vignettes in Patient Safety - Volume 1

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Although the definition of polypharmacy has evolved over time, it has been and remains to be an issue in healthcare. With the prevalence of polypharmacy increasing, those in the health care field must remain vigilant of the adverse effects of medications and work to coordinate care and maintain appropriate prescribing practices. Here we present a clinical vignette that describes an encounter of a patient on multiple medications and the individual, provider, and systems-level issues that may have contributed to an adverse event resulting in a hospital stay. We will discuss the definition of polypharmacy, review the prevalence and economic implications of drug prescription practices, and examine the consequences and complications of polypharmacy in a number of different patient populations. We will discuss a number of scenarios involving polypharmacy that lead to medication errors, decreased quality of life, and patient harm, and then review evidencebased methods of interventions aimed at reducing the prevalence of polypharmacy and its associated complications.

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The depth, duration, and degree of outpatient pediatric polypharmacy in Colorado fee-for-service Medicaid patients

Abstract: Outpatient pediatric polypharmacy occurs to a substantial degree for a small but vulnerable population of children, who may be candidates for pharmacy case management. We must determine whether increased exposure to high-degree polypharmacy causes harm.

Cited by 42 publications

References 21 publications

Variation of the prevalence of pediatric polypharmacy: A scoping review

Variation of the prevalence of pediatric polypharmacy: A scoping review

Health benefits of an adverse events reporting system for chronic pain patients using long‐term opioids

Dangers of Polypharmacy

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