Zanin Anna, Baratiri Fernando, Roverato Barbara, Mengato Daniele, Pivato Lisa, Avagnina Irene, Maghini Irene, Divisic Antuan, Rusalen Francesca, Agosto Caterina, Venturini Francesca, Benini Franca
Palliative Care and Pain Service, Department of Women's and Children's Health, University of Padua, 35128 Padua, Italy.
Department of Women's and Children's Health, University of Padua, 35128 Padua, Italy.
Children (Basel). 2024 Jul 4;11(7):821. doi: 10.3390/children11070821.
Children with medical complexity (CMC) often require multiple medications, leading to polypharmacy, which seems to be linked to adverse effects, administration errors, and increased caregiver burden. This study aimed to describe the prevalence of polypharmacy, medication burden, off-label drug use, and associated costs.
Conducted at the Pediatric Palliative Care Center of Padua, Italy, from August to October 2021, this cross-sectional observational study included patients up to 23 years old with at least one prescribed drug. Data were collected from medical records and caregiver interviews. Drug costs were collected from the Italian Medicine Agency. Descriptive statistical analysis was performed. For comparisons among categorical variables, the Chi-square test was used, and for those among continuous variables, the ANOVA test was used.
This study analyzed treatment regimens of 169 patients with a median age of 12.5 years (0.3-23). Polypharmacy was present in 52.7% of patients, and medication burden was observed in 44.4%, both varying significantly by primary diagnosis ( < 0.001). The median daily cost per patient was EUR 2.2 (IQR 0.9-7.1), with significant variation among subgroups. Only 34.6% of prescriptions were off-label.
polypharmacy and medication burden are frequent among our CMC population, with some differences according to primary diagnosis.
患有复杂疾病的儿童（CMC）通常需要多种药物治疗，这导致了多药联用，而多药联用似乎与不良反应、用药错误以及照顾者负担增加有关。本研究旨在描述多药联用的患病率、用药负担、超说明书用药情况及相关费用。
本横断面观察性研究于2021年8月至10月在意大利帕多瓦的儿科姑息治疗中心进行，纳入了年龄在23岁及以下且至少开具了一种药物的患者。数据从病历和照顾者访谈中收集。药物费用从意大利药品管理局收集。进行描述性统计分析。对于分类变量之间的比较，使用卡方检验；对于连续变量之间的比较，使用方差分析。
本研究分析了169例患者的治疗方案，患者中位年龄为12.5岁（0.3 - 23岁）。52.7%的患者存在多药联用情况，44.4%的患者存在用药负担，两者在不同的主要诊断中均有显著差异（<0.001）。每位患者的每日费用中位数为2.2欧元（四分位间距0.9 - 7.1），各亚组间存在显著差异。只有34.6%的处方为超说明书用药。
在我们的CMC人群中，多药联用和用药负担很常见，且根据主要诊断存在一些差异。
