Paeds Vivas · clinical-assessment-and-reasoning
Medication reconciliation and polypharmacy in children — branching viva
Branching viva on BPMH, discrepancy priority, CMC polypharmacy, liquid dosing and discharge safety.
On this page
Study tools
Target exams
RACP General PaediatricsRACP DCEMRCPCH ClinicalRCPSC Pediatrics
Prompt
You are the paediatric registrar responsible for medication safety across ED, ward and discharge. The examiner will challenge definitions, prioritisation and counselling.
Stem
The examiner will move from definitions to a complex discharge and then to deprescribing. [1] [6]
References36ShowHide
- [1]Merandi J, Sapko M, Catt C, et al. Medication Reconciliation. Pediatrics in review, 2017.PMID 28044039
- [2]Sheth S, Bialostozky M, Hollenbach K, et al. Standardizing Medication Reconciliation in a Pediatric Emergency Department. Pediatrics, 2024.PMID 38273780
- [3]Condren M, Bowling S, Hall B, et al. Medication Reconciliation Across Care Transitions in the Pediatric Medical Home. Joint Commission journal on quality and patient safety, 2019.PMID 30898508
- [4]Morse KE, Chadwick WA, Paul W, et al. Quantifying Discharge Medication Reconciliation Errors at 2 Pediatric Hospitals. Pediatric quality & safety, 2021.PMID 34345749
- [5]Gunkelman SM, Jamerino-Thrush J, Genet K, et al. Improving Accuracy of Medication Reconciliation for Hospitalized Children: A Quality Project. Hospital pediatrics, 2024.PMID 38529561
- [6]Feinstein JA, Orth LE Making Polypharmacy Safer for Children with Medical Complexity. The Journal of pediatrics, 2023.PMID 36252865
- [7]Huth K, Vandecruys P, Orkin J, et al. Medication safety for children with medical complexity. Paediatrics & child health, 2020.PMID 33178368
- [8]Zanin A, Baratiri F, Roverato B, et al. Polypharmacy in Children with Medical Complexity: A Cross-Sectional Study in a Pediatric Palliative Care Center. Children (Basel, Switzerland), 2024.PMID 39062270
- [9]Alqenae FA, Steinke D, Keers RN Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review. Drug safety, 2020.PMID 32125666
- [10]Aires-Moreno GT, Alcântara TDS, Araújo DCSA, et al. Medication discrepancies in transition of care of hospitalised children in Brazil: a multicentric study. Archives of disease in childhood, 2021.PMID 33958348
- [11]Starmer AJ, Spector ND, Srivastava R, et al. Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
- [12]Gattari TB, Krieger LN, Hu HM, et al. Medication Discrepancies at Pediatric Hospital Discharge. Hospital pediatrics, 2015.PMID 26231634
- [13]Louiselle K, Harte L, Thompson C, et al. Medication Discrepancy Risk Factors for Pediatric Patients With Epilepsy at Hospital Admission. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2021.PMID 34035684
- [14]Moss JG, Young D, Rashed AN, et al. Paediatric polypharmacy and deprescribing: the views of UK healthcare professionals. Archives of disease in childhood, 2023.PMID 35701176
- [15]Zito JM, Zhu Y, Safer DJ Psychotropic Polypharmacy in the US Pediatric Population: A Methodologic Critique and Commentary. Frontiers in psychiatry, 2021.PMID 34194346
- [16]DeCourcey DD, Silverman M, Chang E, et al. Medication Reconciliation Failures in Children and Young Adults With Chronic Disease During Intensive and Intermediate Care. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2017.PMID 28198758
- [17]Huynh C, Tomlin S, Jani Y, et al. An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital. Archives of disease in childhood, 2016.PMID 26566687
- [18]Huynh C, Wong IC, Tomlin S, et al. Medication discrepancies at transitions in pediatrics: a review of the literature. Paediatric drugs, 2013.PMID 23670796
- [19]Huynh C, Wong IC, Tomlin S, et al. An evaluation of paediatric medicines reconciliation at hospital discharge into the community. The International journal of pharmacy practice, 2016.PMID 26670624
- [20]Wong JD, Bajcar JM, Wong GG, et al. Medication reconciliation at hospital discharge: evaluating discrepancies. The Annals of pharmacotherapy, 2008.PMID 18780806
- [21]Cornish PL, Knowles SR, Marchesano R, et al. Unintended medication discrepancies at the time of hospital admission. Archives of internal medicine, 2005.PMID 15738372
- [22]Tam VC, Knowles SR, Cornish PL, et al. Frequency, type and clinical importance of medication history errors at admission to hospital: a systematic review. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2005.PMID 16129874
- [23]Kwan JL, Lo L, Sampson M, et al. Medication reconciliation during transitions of care as a patient safety strategy: a systematic review. Annals of internal medicine, 2013.PMID 23460096
- [24]Mueller SK, Sponsler KC, Kripalani S, et al. Hospital-based medication reconciliation practices: a systematic review. Archives of internal medicine, 2012.PMID 22733210
- [25]Coffey M, Mack L, Streitenberger K, et al. Prevalence and clinical significance of medication discrepancies at pediatric hospital admission. Academic pediatrics, 2009.PMID 19640822
- [26]Kulawiak J, Jacobson JL, Miller JA, et al. Evaluation of a Pharmacist-Driven Discharge Medication Reconciliation Service Pilot at a Children's Hospital. The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2024.PMID 39411418
- [27]Grossberg R Polypharmacy-An Important Contributor to Health and Safety for Children With Medical Complexity: How Can We Improve Care for This Vulnerable Population? The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG, 2024.PMID 38596412
- [28]Reedy J, Thompson T, Begum A, et al. Challenges of managing pediatric polypharmacy in a pediatric complex care program: A qualitative pilot study. Journal of the American Pharmacists Association : JAPhA, 2025.PMID 40127839
- [29]Alcântara TDS, de Araújo Neto FC, Lima HF, et al. Prevalence of medication discrepancies in pediatric patients transferred between hospital wards. International journal of clinical pharmacy, 2021.PMID 33175294
- [30]Kuo DZ, Houtrow AJ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
- [31]Kuo DZ, McAllister JW, Rossignol L, et al. Care Coordination for Children With Medical Complexity: Whose Care Is It, Anyway? Pediatrics, 2018.PMID 29496973
- [32]Zennaro M, Trotter A, Mengato D, et al. Improving Medication Safety Through Medication Reconciliation in Pediatric Neurology: Clinical Pharmacist Recommendations and Physician Uptake in a 13-Week Study. Children (Basel, Switzerland), 2025.PMID 40426804
- [33]Adducchio S, Grant ED, Fonseca LD, et al. Reducing Discharge Medication Reconciliation Errors at a Pediatric Neurology Inpatient Unit. Neurology. Clinical practice, 2024.PMID 38524835
- [34]Yin HS, Neuspiel DR, Paul IM, et al. Preventing Home Medication Administration Errors. Pediatrics, 2021.PMID 34851406
- [35]Yin HS, Parker RM, Sanders LM, et al. Pictograms, Units and Dosing Tools, and Parent Medication Errors: A Randomized Study. Pediatrics, 2017.PMID 28759396
- [36]Yin HS, Parker RM, Sanders LM, et al. Effect of Medication Label Units of Measure on Parent Choice of Dosing Tool: A Randomized Experiment. Academic pediatrics, 2016.PMID 27155289