Choosing medications wisely: Is it time to address paediatric polypharmacy?

Area of Science:

• Pediatric Pharmacology
• Medication Safety
• Public Health

Background:

• Polypharmacy (the use of multiple medications) is increasingly recognized in adult populations, but less attention has been paid to its risks in children.
• In pediatric patients, polypharmacy, especially with off-label drug use, elevates the risk of adverse drug reactions (ADRs).

Purpose of the Study:

• To highlight the need for targeted deprescription and pharmacovigilance strategies for pediatric polypharmacy.
• To advocate for improved medication management in children to reduce adverse events and enhance patient experience.

Main Methods:

• Extrapolation of best practices from adult literature, including medication review algorithms and patient education.
• Exploring non-pharmacological interventions for child and youth mental health to reduce reliance on psychotropic medications.

Main Results:

• Current strategies for polypharmacy management are primarily focused on adults, necessitating adaptation for pediatric populations.
• Non-pharmacological approaches show promise in mitigating psychotropic polypharmacy in youth.

Conclusions:

• The pediatric prescribing community must prioritize pharmacovigilance and deprescription initiatives for children with polypharmacy.
• Implementing evidence-based strategies can significantly improve safety and outcomes for pediatric patients on multiple medications, reducing adverse drug events and interactions.