Defining pediatric polypharmacy: A scoping review.

<h4>Objectives</h4>Lack of consensus regarding the semantics and definitions of pediatric polypharmacy challenges researchers and clinicians alike. We conducted a scoping review to describe definitions and terminology of pediatric polypharmacy.<h4>Methods</h4>Medline, PubMed,...

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Main Authors: Paul M Bakaki, Alexis Horace, Neal Dawson, Almut Winterstein, Jennifer Waldron, Jennifer Staley, Elia M Pestana Knight, Sharon B Meropol, Rujia Liu, Hannah Johnson, Negar Golchin, James A Feinstein, Shari D Bolen, Lawrence C Kleinman
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0208047&type=printable
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author Paul M Bakaki
Alexis Horace
Neal Dawson
Almut Winterstein
Jennifer Waldron
Jennifer Staley
Elia M Pestana Knight
Sharon B Meropol
Rujia Liu
Hannah Johnson
Negar Golchin
James A Feinstein
Shari D Bolen
Lawrence C Kleinman
author_facet Paul M Bakaki
Alexis Horace
Neal Dawson
Almut Winterstein
Jennifer Waldron
Jennifer Staley
Elia M Pestana Knight
Sharon B Meropol
Rujia Liu
Hannah Johnson
Negar Golchin
James A Feinstein
Shari D Bolen
Lawrence C Kleinman
author_sort Paul M Bakaki
collection DOAJ
description <h4>Objectives</h4>Lack of consensus regarding the semantics and definitions of pediatric polypharmacy challenges researchers and clinicians alike. We conducted a scoping review to describe definitions and terminology of pediatric polypharmacy.<h4>Methods</h4>Medline, PubMed, EMBASE, CINAHL, PsycINFO, Cochrane CENTRAL, and the Web of Science Core Collection databases were searched for English language articles with the concepts of "polypharmacy" and "children". Data were extracted about study characteristics, polypharmacy terms and definitions from qualifying studies, and were synthesized by disease conditions.<h4>Results</h4>Out of 4,398 titles, we included 363 studies: 324 (89%) provided numeric definitions, 131 (36%) specified duration of polypharmacy, and 162 (45%) explicitly defined it. Over 81% (n = 295) of the studies defined polypharmacy as two or more medications or therapeutic classes. The most common comprehensive definitions of pediatric polypharmacy included: two or more concurrent medications for ≥1 day (n = 41), two or more concurrent medications for ≥31 days (n = 15), and two or more sequential medications over one year (n = 12). Commonly used terms included polypharmacy, polytherapy, combination pharmacotherapy, average number, and concomitant medications. The term polypharmacy was more common in psychiatry literature while epilepsy literature favored the term polytherapy.<h4>Conclusions</h4>Two or more concurrent medications, without duration, for ≥1 day, ≥31 days, or sequentially for one year were the most common definitions of pediatric polypharmacy. We recommend that pediatric polypharmacy studies specify the number of medications or therapeutic classes, if they are concurrent or sequential, and the duration of medications. We propose defining pediatric polypharmacy as "the prescription or consumption of two or more distinct medications for at least one day". The term "polypharmacy" should be included among key words and definitions in manuscripts.
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spelling doaj-art-1bd5722f7c8b43f78b40c8471f7055fa2025-02-05T05:33:09ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-011311e020804710.1371/journal.pone.0208047Defining pediatric polypharmacy: A scoping review.Paul M BakakiAlexis HoraceNeal DawsonAlmut WintersteinJennifer WaldronJennifer StaleyElia M Pestana KnightSharon B MeropolRujia LiuHannah JohnsonNegar GolchinJames A FeinsteinShari D BolenLawrence C Kleinman<h4>Objectives</h4>Lack of consensus regarding the semantics and definitions of pediatric polypharmacy challenges researchers and clinicians alike. We conducted a scoping review to describe definitions and terminology of pediatric polypharmacy.<h4>Methods</h4>Medline, PubMed, EMBASE, CINAHL, PsycINFO, Cochrane CENTRAL, and the Web of Science Core Collection databases were searched for English language articles with the concepts of "polypharmacy" and "children". Data were extracted about study characteristics, polypharmacy terms and definitions from qualifying studies, and were synthesized by disease conditions.<h4>Results</h4>Out of 4,398 titles, we included 363 studies: 324 (89%) provided numeric definitions, 131 (36%) specified duration of polypharmacy, and 162 (45%) explicitly defined it. Over 81% (n = 295) of the studies defined polypharmacy as two or more medications or therapeutic classes. The most common comprehensive definitions of pediatric polypharmacy included: two or more concurrent medications for ≥1 day (n = 41), two or more concurrent medications for ≥31 days (n = 15), and two or more sequential medications over one year (n = 12). Commonly used terms included polypharmacy, polytherapy, combination pharmacotherapy, average number, and concomitant medications. The term polypharmacy was more common in psychiatry literature while epilepsy literature favored the term polytherapy.<h4>Conclusions</h4>Two or more concurrent medications, without duration, for ≥1 day, ≥31 days, or sequentially for one year were the most common definitions of pediatric polypharmacy. We recommend that pediatric polypharmacy studies specify the number of medications or therapeutic classes, if they are concurrent or sequential, and the duration of medications. We propose defining pediatric polypharmacy as "the prescription or consumption of two or more distinct medications for at least one day". The term "polypharmacy" should be included among key words and definitions in manuscripts.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0208047&type=printable
spellingShingle Paul M Bakaki
Alexis Horace
Neal Dawson
Almut Winterstein
Jennifer Waldron
Jennifer Staley
Elia M Pestana Knight
Sharon B Meropol
Rujia Liu
Hannah Johnson
Negar Golchin
James A Feinstein
Shari D Bolen
Lawrence C Kleinman
Defining pediatric polypharmacy: A scoping review.
PLoS ONE
title Defining pediatric polypharmacy: A scoping review.
title_full Defining pediatric polypharmacy: A scoping review.
title_fullStr Defining pediatric polypharmacy: A scoping review.
title_full_unstemmed Defining pediatric polypharmacy: A scoping review.
title_short Defining pediatric polypharmacy: A scoping review.
title_sort defining pediatric polypharmacy a scoping review
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0208047&type=printable
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