Association between polypharmacy and clinical outcomes in children with medical complexity: a retrospective cohort study
-
By
-
Shuangzhu Shao
-
Kafen Hu
-
Jinlong Zhou
-
July 9, 2026
-
Clinical Scorecard: Impact of Multiple Medications on Clinical Outcomes in Pediatric Patients with Medical Complexity: A Retrospective Cohort Analysis
At a Glance
| Category | Detail |
|---|
| Condition | Polypharmacy in Children with Medical Complexity |
| Key Mechanisms | Increased adverse drug events, potentially inappropriate medication use, and reduced medication adherence. |
| Target Population | Children with medical complexity aged 0–18 years. |
| Care Setting | Pediatric healthcare settings. |
Key Highlights
- 42.3% of CMC experienced polypharmacy, defined as 5 or more chronic medications for 90 or more days.
- Polypharmacy was associated with higher rates of adverse drug events (aRR 2.70; 95% CI 2.30–3.20).
- Significantly increased emergency department visits (5.5 vs 2.3 per year) and unplanned admissions (3.5 vs 1.3 per year) in polypharmacy group.
- Lower medication adherence in polypharmacy group (mean PDC 63.5% vs 80.2%).
- Dose-response relationship observed across polypharmacy severity levels.
Guideline-Based Recommendations
Diagnosis
- Identify children with medical complexity using the Pediatric Medical Complexity Algorithm.
Management
- Consider systematic medication optimization and deprescribing protocols.
Monitoring & Follow-up
- Monitor for adverse drug events and medication adherence in CMC.
Risks
- Increased risk of adverse drug events and medication errors due to complex regimens.
Patient & Prescribing Data
Children with medical complexity receiving ongoing care.
Polypharmacy is prevalent and associated with significant clinical risks.
Clinical Best Practices
- Implement enhanced medication reconciliation processes.
- Conduct multidisciplinary reviews of medication regimens.
Related Resources & Content
