ArticleThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG2026
A Qualitative Study of Parent and Health Care Provider Perspectives on Polypharmacy in Children With Medical Complexity.
Article in The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo understand contributing factors and possible solutions to polypharmacy in children with medical complexity (CMC) from the perspective of family caregivers and clinicians.
methodsUsing group-level assessment (GLA), a structured large-group qualitative method, family caregiver and clinician participants individually generated responses to semi-structured prompts, analyzed responses in small groups, and reached group consensus on themes. Investigators merged themes across GLA sessions. To substantiate GLA findings, we conducted semi-structured interviews with CMC caregivers. Using a combined inductive/deductive approach based on GLA themes, we integrated interview findings into final themes.
resultsWe conducted 4 GLA sessions with CMC family caregivers and clinicians (n = 37) and 4 semi-structured interviews with family caregivers. Final themes highlighted how clinicians and families prioritize possible benefits to medications, leading to a willingness to start medications, often without a clear plan to reassess, and a reluctance to stop medications related to fears of disrupting the child's state of health. Challenges communicating between multiple subspecialists and inadequate partnership with CMC caregivers potentiate challenges of polypharmacy.
conclusionsParticipants emphasized the cycle of prescribing cascades and hesitancy to deprescribe as contributing to polypharmacy. Findings related to communication challenges and caregiver partnership imply standard medication management processes incorporating family input are warranted.
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