Medication Management Service Opportunity Benefits Children With Medical Complexity

A pharmacist-guided pediatric medication therapy management service stands to benefit most children with medical complexity, according to study findings published in the Journal of the American Pharmacists Association.

“In this retrospective study, a standardized systematic approach to pediatric medication therapy management identified medication-related concerns and potential interventions for nearly all patients with medical complexity,” wrote researchers. “Pediatric patients receiving 5 or more medications had the potential to experience significant reductions in medication regimen complexity following the pediatric medication therapy management intervention, suggesting opportunities for targeted services to improve medication-related outcomes.”

The study focused on 100 children with medical complexity in a larger outpatient primary care medical home within a children’s hospital.

On average, the medication therapy management model identified an average 3.4 ± 0.3 medication-related concerns per child. Inappropriate or unnecessary therapy, suboptimal therapy, under treated symptoms, adverse effects, drug-drug interactions, or duplication of therapy were common issues, according to the study.

Some 97% of patients showed opportunity for 5.0 ± 2.9 interventions each. The most frequently proposed interventions were drug discontinuation trials (69%), patient/caregiver education (55%), dosage form modifications (51%), dose modifications (49%), and frequency modifications (46%).

Among all patients, the average Medication Regimen Complexity Index (MRCI) score at baseline was 32.6. Applying theoretical interventions would decrease MRCI scores an average 4.9 points, suggested study authors.

“Further prospective evaluation of a pharmacist-guided pediatric medication therapy service is warranted,” wrote researchers.

Reference:
Marquez C, Thompson R, Feinstein JA, Orth LE. Identifying opportunities for pediatric medication therapy management in children with medical complexity. J Am Pharm Assoc. Published online April 11, 2022. doi:10.1016/j.japh.2022.04.005