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Polypharmacy in children and young people with life-limiting conditions from 2000 to 2015: A Repeated Cross-sectional Study in England

Research output: Contribution to journalArticlepeer-review

Lorna Katharine Fraser, Deborah Gibson-Smith, Stuart William Jarvis, Andrew John Papworth, V Neefjes, M Hills, Timothy Doran, Johanna Taylor

Original languageEnglish
Pages (from-to)213-221.e1
Number of pages3
JournalJournal of Pain and Symptom Management
Issue number3
Published3 Sep 2022

Bibliographical note

Funding Information: SJ is funded by a National Institute for Health Research Doctoral Research Fellowship (award DRF-2018-11-ST2-013) for this research project. LF is funded by a National Institute for Health Research Career Development Fellowship (award: CDF-2018-11-ST2-002) for this research project. This publication presents independent research funded by the National Institute for Health Research. The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care. Funding Information: This article presents independent research partly funded by the Wellcome Trust (Ref. No. 204829) through the Centre for Future Health at the University of York, and the Martin House Research Centre which is a partnership between the University of York and Martin House Hospice Care for Children and Young People. The views expressed are those of the authors and not necessarily those of the Wellcome Trust, the University of York or Martin House Hospice. Publisher Copyright: © 2022 The Authors

King's Authors


Context: Polypharmacy is often appropriate for children with life-limiting conditions but is associated with an increase in hospitalizations and inappropriate prescribing, and can affect the quality of life of children and their families as they manage complex medication schedules. Despite this, little is known about polypharmacy in this population. Objective: To describe the prevalence and patterns of polypharmacy in children with a life-limiting condition in a nationally representative cohort in England. Methods: Observational study of children (age 0–19 years) with a life-limiting condition in a national database from 2000 to 2015. Common definitions of polypharmacy were used to determine polypharmacy prevalence in each year based on unique medications and regular medications. Hierarchical regression analyses were used to explore factors associated with polypharmacy. Results: Data on 15,829 individuals were included. Each year 27%–39% of children were prescribed ≥5 unique medications and 8%–12% were prescribed ≥10. Children with a respiratory (OR 7.6, 95%CI 6.4–9.0), neurological (OR 2.8, 95%CI 2.4–3.2), or metabolic (OR 2.2, 95%CI 1.7–2.8) condition were more likely than those with a congenital condition to experience polypharmacy. Increasing age, being diagnosed with a LLC under one year of age, having >1 life-limiting or chronic condition or living in areas of higher deprivation were also associated with higher prevalence of polypharmacy. Conclusion: Children with life-limiting conditions have a high prevalence of polypharmacy and some children are at greater risk than others. More research is needed to understand and address the factors that lead to problematic polypharmacy in this population.

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