Home Medication Regimen Complexity in Newly Diagnosed Pediatric Oncology Patients

Parents of children newly diagnosed with cancer require specialized education to provide care for their child at home, including the management of complex medication regimens.

To assess the complexity of home medication regimens in a cohort of newly diagnosed pediatric oncology patients.

We inventoried and categorized all discharge medications for each patient and used the Medication Regimen Complexity Index (MRCI) to quantify the complexity of the prescribed medication regimens. We used logistic regression to identify patient sociodemographic and clinical characteristics significantly (P < .05) associated with higher medication burden (ie, higher total MRCI scores).

The cohort consisted of 105 newly diagnosed pediatric oncology patients initially hospitalized between December 2016 and February 2019 (61.9% male, 65.7% non-Hispanic White, 65.7% leukemia or lymphoma; median [range] age at diagnosis, 7.1 [0.4-17.7] years; median [range] number of discharge medications, 9 [1-14]). The proportion of patients prescribed ≥1 medication in each pharmacologic category was as follows: antiemetics, 94.3%; antimicrobials, 93.3%; pain management, 88.6%; oral care, 86.7%; stool softeners/laxatives, 81.0%; gastrointestinal protectants, 60.0%; cancer-directed therapy, 51.5%, other supportive therapies, 49.5%, other, 27.6%. Characteristics associated with ≥ median (≥33.0) MRCI score included a diagnosis of leukemia or lymphoma (odds ratio, 2.7; 95% confidence interval, 1.1-6.6; P = .027; comparison: solid tumor) and older age (odds ratio, 1.1 per year; 95% confidence interval, 1.0-1.2; P = .020).

Most children newly diagnosed with cancer are discharged with complex medication regimens that parents/caregivers must manage at home.

Nurses can use these findings to develop tailored medication education plans for parents/caregivers of newly diagnosed pediatric oncology patients.