Publication
COMMUNITY PAEDIATRIC MEDICATION LISTS FOR CHILDREN WITH COMPLEX AND PALLIATIVE CARE NEEDS
Gaskell C, Crampton R, Martin A, Heckford E, Williams A, Wiltshire S, Taylor S · BMJ Paediatrics Open · 2025
Context Children and young people have a risk of medication errors and those with complex and/or life limiting conditions have a higher risk due to polypharmacy, complex medication regimens, and frequent transitions of care, often with multiple organisations delivering care.1 Within the area local to our children's hospital we reviewed administration practice. Care providers include two community nursing teams and a hospice team who each used their own prescription lists and administration records. The creation of lists was a duplication of workload. None of the individual organisations nor the GP had a comprehensive oversight of the patients' full medication list because many children are being prescribed and supplied medications from both primary and secondary care. An improved process for sharing information about medicines when transferring between care settings is important.2 3 The patient safety risks of this cross-organisational practice was a concern, so we came together to find a solution. A new Community Paediatric Medication List (CPML) service was developed with collaboration between the tertiary children's paediatric palliative care team, the community nursing teams and the hospice team. 50 children with the highest need met our proposed inclusion criteria and parents/carers were offered the pilot service, a CPML maintained by the hospital pharmacists. The pharmacists compiled the patient's medication list by accessing multiple information sources. They carried out a medicines optimisation exercise and then widely circulated the CPML using local electronic health records. The CPML is used by the community teams to enable safe administration of medicines during their care delivery. It is an accurate medication history resource for all other healthcare professionals involved in delivering care. One day per week pharmacist time is dedicated to reviewing and updating the lists with an aim to ensure each list is updated at least monthly. Lessons Learned A review of the service was carried out after 2 years with family and healthcare professional questionnaires, and a focus group with parents/carers to explore issues raised further. This showed positive feedback from clinical teams using the lists who feel it has made the process of administering medicines in patient's homes and writing hospice drug charts more efficient and safer. Feedback from families has shown that for most parents/carers, the CPML has been helpful, improved care and has improved how parents communicate about medicines. It has also strengthened links between teams to enable better working and more seamless care for patients and given complex patients the benefit of a regular specialist pharmacist review of their medication. The medicine optimisation exercise found many medication concerns that were all resolved. The main barrier to maintaining the lists has been communication and getting engagement from some parents/carers. There is also work to be done to ensure all relevant staff are aware of and can access the lists, and to expand their use to other teams involved in the care of these patients.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.