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Caregiver Perspectives on Polypharmacy Management in Children With Medical Complexity.

Lucas E Orth1,2, Julia Reedy3, Talia Thompson3,4

  • 1Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy & Pharmaceutical Sciences, Aurora, Colorado.

Pediatrics
|July 14, 2026
PubMed
Summary

Caregivers of children with medical complexity (CMC) face significant psychosocial burdens managing polypharmacy. Understanding their experiences is key to improving medication management and reducing caregiver stress.

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Area of Science:

  • Pediatric healthcare
  • Pharmacotherapy management
  • Caregiver support

Background:

  • Children with medical complexity (CMC) often require polypharmacy (≥5 medications).
  • Polypharmacy increases the risk of medication-related problems in CMC.
  • Caregiver experiences managing outpatient polypharmacy for CMC are not well understood.

Purpose of the Study:

  • To explore caregivers' lived experiences managing polypharmacy for CMC.
  • To develop a conceptual model of factors influencing outpatient polypharmacy management.
  • To inform patient- and caregiver-centered interventions.

Main Methods:

  • Grounded theory methodology with semistructured interviews.
  • Recruitment of 21 caregivers of CMC with polypharmacy.
  • Constant comparative analysis and triangulation for rigor.

Main Results:

  • Caregivers experience significant psychosocial burden managing complex medication regimens.
  • Variable quality of healthcare interactions impacts management.
  • Adaptation to dynamic medication needs influences adherence.
  • A model of influential factors for polypharmacy management was developed.

Conclusions:

  • A model highlights the need for interventions supporting pharmacotherapy and reducing caregiver burden.
  • Patient- and caregiver-centered approaches are crucial for improving medication management in CMC.
  • Enhanced clinical support can improve adherence and outcomes for CMC on polypharmacy.