Courtney Baker1, James A Feinstein2, Xuan Ma1, Shari Bolen3,4, Neal V Dawson3,4, Negar Golchin5, Alexis Horace6, Lawrence C Kleinman7,8, Sharon B Meropol7,8,9, Elia M Pestana Knight10, Almut G Winterstein11, Paul M Bakaki1. 1. Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA. 2. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA. 3. Center for Health Care Research and Policy, MetroHealth, Cleveland, OH, USA. 4. Department of Medicine, MetroHealth Medical Center, Cleveland, OH, USA. 5. School of Pharmacy, University of Washington, Seattle, WA, USA. 6. Department of Clinical Sciences, University of Louisiana at Monroe College of Pharmacy, Monroe, LA, USA. 7. UH Rainbow The Center for Child Health and Policy, University Hospitals, Cleveland, OH, USA. 8. School of Medicine, Case Western Reserve University, Cleveland, OH, USA. 9. Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 10. Epilepsy Center/Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. 11. Department of Pharmaceutical Outcomes and Policy and Department of Epidemiology, University of Florida, Gainesville, FL, USA.
Abstract
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.
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.
Authors: Adriana Cristina de Souza Gonçalves; Adriano Max Moreira Reis; Ana Carolina Marçal Gusmão; Maria Cândida Ferrarez Bouzada Journal: Int J Clin Pharm Date: 2015-04-02
Authors: Cynthia A Fontanella; Lynn A Warner; Gary S Phillips; Jeffrey A Bridge; John V Campo Journal: Psychiatr Serv Date: 2014-10-31 Impact factor: 3.084
Authors: Dingwei Dai; James A Feinstein; Wynne Morrison; Athena F Zuppa; Chris Feudtner Journal: Pediatr Crit Care Med Date: 2016-05 Impact factor: 3.624
Authors: Praveen Kumar; Jennifer K Walker; Kristin M Hurt; Kimberly M Bennett; Neal Grosshans; Michael A Fotis Journal: J Pediatr Date: 2007-10-22 Impact factor: 4.406
Authors: Mai T Pham; Andrijana Rajić; Judy D Greig; Jan M Sargeant; Andrew Papadopoulos; Scott A McEwen Journal: Res Synth Methods Date: 2014-07-24 Impact factor: 5.273
Authors: Vishal Sehgal; Sukhminder Jit Singh Bajwa; Rinku Sehgal; Anurag Bajaj; Upinder Khaira; Victoria Kresse Journal: J Family Med Prim Care Date: 2013-04
Authors: Amy Pan; Sierra Scodellaro; Tayyaba Khan; Inna Ushcatz; Wendy Wu; Meredith Curtis; Eyal Cohen; Ronald D Cohn; Robin Z Hayeems; M Stephen Meyn; Julia Orkin; Jaskiran Otal; Miriam S Reuter; Susan Walker; Stephen W Scherer; Christian R Marshall; Iris Cohn; Gregory Costain Journal: Pediatr Res Date: 2022-09-27 Impact factor: 3.953
Authors: James A Feinstein; Hannah Friedman; Lucas E Orth; Chris Feudtner; Allison Kempe; Sadaf Samay; Allison B Blackmer Journal: JAMA Netw Open Date: 2021-08-02
Authors: Celeste L Y Ewig; Yi Man Cheng; Hoi Shan Li; Jasper Chak Ling Wong; Alex Hong Yu Cho; Freddie Man Hong Poon; Chi Kong Li; Yin Ting Cheung Journal: Front Oncol Date: 2021-04-01 Impact factor: 6.244
Authors: Deborah Winders Davis; W David Lohr; Yana Feygin; Liza Creel; Kahir Jawad; V Faye Jones; P Gail Williams; Jennifer Le; Marie Trace; Natalie Pasquenza Journal: BMC Psychiatry Date: 2021-06-10 Impact factor: 3.630