{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:45:53Z","timestamp":1791812753821,"version":"4.3.4"},"reference-count":53,"publisher":"The Pediatric Pharmacy Association","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To understand contributing factors and possible solutions to polypharmacy in children with medical complexity (CMC) from the perspective of family caregivers and clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>We 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\u2019s state of health. Challenges communicating between multiple subspecialists and inadequate partnership with CMC caregivers potentiate challenges of polypharmacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Participants 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5863\/jppt-25-00152","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:50:45Z","timestamp":1791809445000},"page":"644-652","source":"Crossref","is-referenced-by-count":0,"title":["A Qualitative Study of Parent and Health Care Provider Perspectives on Polypharmacy in Children With Medical Complexity"],"prefix":"10.5863","volume":"31","author":[{"given":"Abigail","family":"Musial","sequence":"first","affiliation":[{"name":"Ranken Jordan Pediatric Bridge Hospital (AM), Maryland Heights, MO"},{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna E.","family":"Thomson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine (AM, JET, LMV, KAA, AMS, ACS), University of Cincinnati, Educational and Community-Based Action Research PhD program, College of Education (LMV), University of Cincinnati, Cincinnati, OH"},{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison M.","family":"Wiedeman","sequence":"additional","affiliation":[{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"Vaughn","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine (AM, JET, LMV, KAA, AMS, ACS), University of Cincinnati, Educational and Community-Based Action Research PhD program, College of Education (LMV), University of Cincinnati, Cincinnati, OH"},{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine A.","family":"Auger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine (AM, JET, LMV, KAA, AMS, ACS), University of Cincinnati, Educational and Community-Based Action Research PhD program, College of Education (LMV), University of Cincinnati, Cincinnati, OH"},{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Blum","sequence":"additional","affiliation":[{"name":"Division of Pharmacy (AB), Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela M.","family":"Statile","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine (AM, JET, LMV, KAA, AMS, ACS), University of Cincinnati, Educational and Community-Based Action Research PhD program, College of Education (LMV), University of Cincinnati, Cincinnati, OH"},{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Stiehl","sequence":"additional","affiliation":[{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda C.","family":"Schondelmeyer","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, College of Medicine (AM, JET, LMV, KAA, AMS, ACS), University of Cincinnati, Educational and Community-Based Action Research PhD program, College of Education (LMV), University of Cincinnati, Cincinnati, OH"},{"name":"James M. Anderson Center for Health Systems Excellence (JET, KAA, AMS, ACS), Cincinnati Children\u2019s Hospital Medical Center, Division of Hospital Medicine (AM, JET, AMW, KAA, AMS), Cincinnati Children\u2019s Hospital Medical Center, Division of Emergency Medicine (LMV), Cincinnati Children\u2019s Hospital Medical Center, Division of Pharmacy (SS), Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3883","reference":[{"issue":"5","key":"JPPT-25-00152-b01","series-title":"Pediatr Crit Care Med","first-page":"e218","article-title":"Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children\u2019s hospitals","volume":"17","author":"Dai","year":"2016","unstructured":"Dai D, Feinstein JA, Morrison W, et al. Epidemiology of polypharmacy and potential drug-drug interactions among pediatric patients in ICUs of U.S. children\u2019s hospitals. 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