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Trajectories of medication use and polypharmacy among children with cerebral palsy

BACKGROUND: Children with cerebral palsy (CP) may have chronic exposure to polypharmacy to address several medical needs, but there is little research on the topic to inform surveillance methods and clinical practice. OBJECTIVES: To identify the trajectories of medication number and pediatric polyph...

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Autores principales: Pruente, Jessica, Daunter, Alecia K, Bowman, Angeline, Erickson, Steven R, Whibley, Daniel, Whitney, Daniel G
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387963/
https://www.ncbi.nlm.nih.gov/pubmed/36580123
http://dx.doi.org/10.18553/jmcp.2023.29.1.58
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author Pruente, Jessica
Daunter, Alecia K
Bowman, Angeline
Erickson, Steven R
Whibley, Daniel
Whitney, Daniel G
author_facet Pruente, Jessica
Daunter, Alecia K
Bowman, Angeline
Erickson, Steven R
Whibley, Daniel
Whitney, Daniel G
author_sort Pruente, Jessica
collection PubMed
description BACKGROUND: Children with cerebral palsy (CP) may have chronic exposure to polypharmacy to address several medical needs, but there is little research on the topic to inform surveillance methods and clinical practice. OBJECTIVES: To identify the trajectories of medication number and pediatric polypharmacy (≥2 concurrent medications) exposure over 3.5 years among children with CP. METHODS: This cohort study used commercial claims from January 1, 2015, to December 31, 2018 (4-year period). Children with CP, aged 5-18 years by January 1, 2016, and with continuous health plan enrollment for all 4 years, were included and categorized as with or without co-occurring neurological/ RESULTS: Of the 1,252 children with CP, 600 were in the CP only cohort (mean [SD]; age, 11.4 [4.1] years; 46.0% female) and 652 were in the CP + NDDs cohort (age, 11.9 [4.1] years; 41.3% female; 32.7% had ≥2 of the NDDs). For the primary GBTM, 3 trajectory groups were identified for CP only: on average, no prescribed medications (69.7% of the cohort), 1 medication/month (24.8%), and 4 medications/month (5.5%). Five trajectory groups were identified for CP + NDDs: 0 (22.4%), 1 (25.6%), 2 (25.2%), 4 (18.4%), and 6 (8.4%) prescribed medications/month. For the secondary GBTM, 3 trajectory groups were identified for CP only: 80.5% were characterized as negligible probability of polypharmacy exposure, 10.8% as low probability, and 8.7% as high probability. Five trajectory groups were identified for CP + NDDs: 37.9% as negligible probability of polypharmacy exposure, 32.8% as constantly high probability, and 29.2% as changing probability (eg, increasing/decreasing). CONCLUSIONS: Children with CP are chronically exposed to differing levels of polypharmacy. Findings can help establish polypharmacy surveillance practices. Studies need to determine if polypharmaceutical strategies are balanced to optimize health and development for children with CP.
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spelling pubmed-103879632023-07-31 Trajectories of medication use and polypharmacy among children with cerebral palsy Pruente, Jessica Daunter, Alecia K Bowman, Angeline Erickson, Steven R Whibley, Daniel Whitney, Daniel G J Manag Care Spec Pharm Research BACKGROUND: Children with cerebral palsy (CP) may have chronic exposure to polypharmacy to address several medical needs, but there is little research on the topic to inform surveillance methods and clinical practice. OBJECTIVES: To identify the trajectories of medication number and pediatric polypharmacy (≥2 concurrent medications) exposure over 3.5 years among children with CP. METHODS: This cohort study used commercial claims from January 1, 2015, to December 31, 2018 (4-year period). Children with CP, aged 5-18 years by January 1, 2016, and with continuous health plan enrollment for all 4 years, were included and categorized as with or without co-occurring neurological/ RESULTS: Of the 1,252 children with CP, 600 were in the CP only cohort (mean [SD]; age, 11.4 [4.1] years; 46.0% female) and 652 were in the CP + NDDs cohort (age, 11.9 [4.1] years; 41.3% female; 32.7% had ≥2 of the NDDs). For the primary GBTM, 3 trajectory groups were identified for CP only: on average, no prescribed medications (69.7% of the cohort), 1 medication/month (24.8%), and 4 medications/month (5.5%). Five trajectory groups were identified for CP + NDDs: 0 (22.4%), 1 (25.6%), 2 (25.2%), 4 (18.4%), and 6 (8.4%) prescribed medications/month. For the secondary GBTM, 3 trajectory groups were identified for CP only: 80.5% were characterized as negligible probability of polypharmacy exposure, 10.8% as low probability, and 8.7% as high probability. Five trajectory groups were identified for CP + NDDs: 37.9% as negligible probability of polypharmacy exposure, 32.8% as constantly high probability, and 29.2% as changing probability (eg, increasing/decreasing). CONCLUSIONS: Children with CP are chronically exposed to differing levels of polypharmacy. Findings can help establish polypharmacy surveillance practices. Studies need to determine if polypharmaceutical strategies are balanced to optimize health and development for children with CP. Academy of Managed Care Pharmacy 2023-01 /pmc/articles/PMC10387963/ /pubmed/36580123 http://dx.doi.org/10.18553/jmcp.2023.29.1.58 Text en Copyright © 2023, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Research
Pruente, Jessica
Daunter, Alecia K
Bowman, Angeline
Erickson, Steven R
Whibley, Daniel
Whitney, Daniel G
Trajectories of medication use and polypharmacy among children with cerebral palsy
title Trajectories of medication use and polypharmacy among children with cerebral palsy
title_full Trajectories of medication use and polypharmacy among children with cerebral palsy
title_fullStr Trajectories of medication use and polypharmacy among children with cerebral palsy
title_full_unstemmed Trajectories of medication use and polypharmacy among children with cerebral palsy
title_short Trajectories of medication use and polypharmacy among children with cerebral palsy
title_sort trajectories of medication use and polypharmacy among children with cerebral palsy
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387963/
https://www.ncbi.nlm.nih.gov/pubmed/36580123
http://dx.doi.org/10.18553/jmcp.2023.29.1.58
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