Association between polypharmacy and clinical outcomes in children with medical complexity: a retrospective…

Cohort studyFrontiers in pediatrics· 2026

Association between polypharmacy and clinical outcomes in children with medical complexity: a retrospective cohort study.

Shuangzhu Shao, Kafen Hu, Jinlong Zhou

GeriatricsCohort studyClinical practiceQ1IF 2.2

Polypharmacy linked to nearly triple the adverse drug event rate in medically complex children

Association between polypharmacy and clinical outcomes in children with medical complexity: a retrospective cohort study.

Shuangzhu Shao … Jinlong Zhou

Frontiers in pediatrics · 2026

Background

IMPORTANCE: Children with medical complexity (children with medical complexity) frequently receive multiple medications, yet the impact of polypharmacy on clinical outcomes in this population remains inadequately characterized.

Purpose

To determine the association between polypharmacy and adverse drug events (adverse drug events), medication appropriateness, adherence, and healthcare utilization in children with medical complexity.

Methods

Retrospective cohort study of 1,486 children with medical complexity aged 0-18 years at The People's Hospital of Danyang, Affiliated Danyang Hospital of Nantong University between January 2019 and June 2021, with minimum 12-month follow-up.

Results

polypharmacy nearly tripled the adjusted adverse drug event rate

RR 2.70 (95% CI 2.30 to 3.20)

CI excludes the null - significant

More results

Of 1,486 children with medical complexity, 628 (42.3%) had polypharmacy.

A dose-response relationship was observed ( P for trend < 0.001).

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Conclusion · 1 of 2

Polypharmacy in children with medical complexity was strongly associated with increased adverse drug events, potentially inappropriate medication use, reduced adherence, and elevated healthcare utilization.

Conclusion · 2 of 2

These findings warrant prospective studies of medication optimization in this population.

Association between polypharmacy and clinical outcomes in children with medical complexity: a retrospective cohort study.

Association between polypharmacy and clinical outcomes in children with medical complexity: a retrospective cohort study.

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