BackgroundPolypharmacy may be necessary in a patient with complex disease or multiple illnesses. Problematic polypharmacy (PP) is defined as the prescribing of multiple medications inappropriately, or where the intended benefit of the medication is not realised. Identification and management of PP already occurs in adult medicine, with evidence based guidelines and deprescribing tools available. This work aims to establish the extent of polypharmacy affecting children at our centre, and the existence of evidence based de-prescribing guidelines to manage potential PP.MethodsAudit of children and young people prescribed medications at a secondary and tertiary children’s hospital, January - December 2017. A systematic review looking for evidence of such a deprescribing tool or guideline was registered with PROSPERO, and undertaken. Inclusion criteria specified the need for a guideline or deprescribing tool in children from birth to < 18yrs of age. Two independent reviewers performed the review with a third reviewer resolving any discrepancies.ResultsWithin a secondary and tertiary care children’s hospital, 668 children were identified as receiving >10 drugs concurrently, while 30 were receiving >20 drugs at one time.The systematic review identified 563 papers initially, with 482 remaining once duplicates were removed. After application of inclusion and exclusion criteria, two studies were included, POPI (Prot-Labarthe et al, 2014) and PIPc (Barry et al, 2016). These papers discuss systems to identify inappropriate prescriptions. No evidence based guidelines related to the management of potential PP in children were identified.ConclusionThere are children receiving a large number of medicines concurrently, putting them at risk of PP. No specific deprescribing guideline or tools to guide management were identified. Paediatric clinical pharmacology is well placed to create and implement such guidelines.Disclosure(s)Nothing to disclose
P70 Identifying and managing problematic polypharmacy in children and young people?
