Special Issue "Development of a National Pediatric Pharmacotherapy Collaborative Practice Network"

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (1 March 2019).

Special Issue Editors

Dr. Richard H. Parrish II
E-Mail Website
Guest Editor
1. Director and Chief Pharmacist and Director, St. Christopher's Hospital for Children, 160 East Erie Avenue, Philadelphia, PA 19134, USA
2. Clinical Associate Professor (affiliate), School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA
Tel. +1 (215) 427-5317; Fax: +1 (215) 427-4827
Interests: pharmacy pediatrics; perioperative care; medication management; health informatics; clinical administration
Special Issues and Collections in MDPI journals
Prof. Johannes N. Van den Anker
E-Mail Website
Guest Editor
1. Department of Paediatric Pharmacology, Universitäts-Kinderspital beider Basel (UKBB, Spitalstrasse 33, CH-4031 Basel, Switzerland
2. Division of Clinical Pharmacology, Children's National Health System, 111 Michigan Avenue, N.W., Washington, D.C. 20010
3. Intensive Care and Department of Paediatric Surgery, Erasmus Medical Center – Sophia Children’s Hospital, Rotterdam, the Netherlands
Interests: developmental pharmacology; neonatal pharmacology; paediatric pharmacology; neonatal medicine; neonatal infectious diseases; pharmacokinetics; pharmacodynamics; neonatal clinical trials
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

Understanding and managing the pharmacotherapy of children with special health care needs (CSHCN), with medical complexity (CMC), safely is very challenging due to a number of individual, multi-disciplinary, and systems-based issues, especially those that require the use of compound sterile (pCSPs) and non-sterile preparations (pCNSPs) for children with chronic and/or rare diseases. For over five years, efforts to raise awareness of the need to create a conceptual framework for meeting CSHCN needs comprised of four pillars—formulation, information, collaboration, and innovation. In 2015, a Special Issue in Pharmacy, called “Pharmacy Paediatrics”, discussed formulation and information issues related to medicines management for children; that is to say, problems primarily related to the lack of standardized pCNSP recipes and of electronic identifiers for them. Efforts are underway through the auspices of the United States Pharmacopeia to address the issues related to (1) science-informed recipes and (2) the exchange of compounded drug preparation information in health information technology systems.

This Special Issue in Children, “Development of a National Pharmacotherapy Collaborative Practice Network for Children”, will encompass the collaboration and innovation matters related to creation of a comprehensive and systematic approach to the design of an ambulatory care system for children that includes (1) establishment of multi-disciplinary practice networks; (2) formulator/ compounder /manufacturer partnerships; and (3) pragmatic clinical trials to support the evolution of evidence-based outcomes.

Manuscripts written jointly by pediatricians and clinical pharmacists are welcome in the following areas:

(1) address the need for development of a national multi-disciplinary pharmacotherapy collaborative practice network;

  1. micro aspects—setting up a collaborative practice
  2. macro aspects—organizational structure and partnerships, design requirements, and shared EHR needs
  3. integration of micro and macro—achieving and measuring positive outcomes in CSHCN (formulation, information, collaboration, and innovation)

(2) assess and suggest sub-specialty practice needs within pediatric pharmacotherapy and clinical pharmacy medication management;

  1. endocrinology
  2. gastroenterology
  3. genetics
  4. hematology/oncology
  5. immunology - HIV/AIDS
  6. nephrology
  7. neurology/psychiatry
  8. oncology
  9. pulmonology
  10. primary pediatrics

(3) integrate complementary and alternative medicine providers and their patients within an evolving medication safety net for ensuring system-level medication needs assessment, formulation and research.

Interested authors are welcome to contribute papers to this collection and to inquire with the editors regarding any questions about paper ideas, content, and scope of the Special Issue.

Sincerely,

Dr. Richard Parrish
Prof. Johannes N. van den Anker
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Children with special health care needs (CSHCN)
  • Collaborative practice
  • Clinical pharmacy
  • Medical complexity
  • Medication management
  • Pediatrics
  • Pharmacotherapy

Published Papers (8 papers)

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Editorial

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Open AccessEditorial
Making Meaningful Improvements in Pharmacotherapy and Medication Management for Children and Youth—A Modest Proposal
Children 2019, 6(10), 111; https://doi.org/10.3390/children6100111 - 09 Oct 2019
Abstract
The Special Issue, “Development of a National Pediatric Pharmacotherapy Collaborative Practice Network,” has illuminated the vital global need for better care coordination and interprofessional collaboration in pharmacotherapy and medication management of children with medical complexity and special healthcare needs (CSHCN-CMC) [...] Full article
Open AccessEditorial
Where are the Ambulatory Care Pediatric Pharmacists?
Children 2019, 6(2), 25; https://doi.org/10.3390/children6020025 - 07 Feb 2019
Abstract
This editorial describes the purposes and content of the Special Issue for the development of a national pediatric pharmacotherapy collaborative practice network. A collaborative practice network from a population health perspective is needed to better manage the medication-related needs of children with special [...] Read more.
This editorial describes the purposes and content of the Special Issue for the development of a national pediatric pharmacotherapy collaborative practice network. A collaborative practice network from a population health perspective is needed to better manage the medication-related needs of children with special health care needs and medical complexity (CSHCN-CMC). Over the last 25 years, the pharmacy profession has been engaged in organized efforts both to elevate practice and educational standards for pediatric pharmacy practice and to design medication management systems that benefit children and their families and caregivers. Moreover, alignment with pediatric clinical pharmacologists will aid in the development of new practice-based research paradigms that can be applied in the clinical setting. Formalized multi-disciplinary collaboration (CPAs) with new approaches to specialized electronic medication systems and comprehensive medication management (CMM) is necessary to improve the pharmacotherapy outcomes of pediatric patients. Full article

Research

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Open AccessArticle
Pediatric Compounding Pharmacy: Taking on the Responsibility of Providing Quality Customized Prescriptions
Children 2019, 6(5), 66; https://doi.org/10.3390/children6050066 - 04 May 2019
Cited by 1
Abstract
Compounding pharmacy has an important role to play in the field of pediatric medicine. These specialized pharmacies can offer solutions to the unique patient needs that arise in the pediatric population. Medication can be tailored to the child to allow better compliance in [...] Read more.
Compounding pharmacy has an important role to play in the field of pediatric medicine. These specialized pharmacies can offer solutions to the unique patient needs that arise in the pediatric population. Medication can be tailored to the child to allow better compliance in cases when the commercial product is unable to meet the needs of the patient. For example, a suspension, suppository, or lozenge formulation is sometimes needed when the manufactured products are only offered as solid oral dosage forms. Sensory processing disorder (SPD), patients with food allergies, and specific dietary needs can also be a big challenge for caregivers and practitioners who need alternatives to the commercially available forms. Three example cases are presented to help describe the process of collaboration between the pharmacist, patient, and doctor to solve the patient’s needs. Full article
Open AccessArticle
Creating a Pharmacotherapy Collaborative Practice Network to Manage Medications for Children and Youth: A Population Health Perspective
Children 2019, 6(4), 58; https://doi.org/10.3390/children6040058 - 09 Apr 2019
Cited by 1
Abstract
Children with special health care needs (CSHCN) use relatively high quantities of healthcare resources and have overall higher morbidity than the general pediatric population. Embedding clinical pharmacists into the Patient-Centered Medical Home (PCMH) to provide comprehensive medication management (CMM) through collaborative practice agreements [...] Read more.
Children with special health care needs (CSHCN) use relatively high quantities of healthcare resources and have overall higher morbidity than the general pediatric population. Embedding clinical pharmacists into the Patient-Centered Medical Home (PCMH) to provide comprehensive medication management (CMM) through collaborative practice agreements (CPAs) for children, especially for CSHCN, can improve outcomes, enhance the experience of care for families, and reduce the cost of care. Potential network infrastructures for collaborative practice focused on CSHCN populations, common language and terminology for CMM, and clinical pharmacist workforce estimates are provided. Applying the results from the CMM in Primary Care grant, this paper outlines the following: (1) setting up collaborative practices for CMM between clinical pharmacists and pediatricians (primary care pediatricians and sub-specialties, such as pediatric clinical pharmacology); (2) proposing various models, organizational structures, design requirements, and shared electronic health record (EHR) needs; and (3) outlining consistent documentation of CMM by clinical pharmacists in CSHCN populations. Full article
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Open AccessArticle
Toolkit for Population Health Initiatives Around the Globe Related to Collaborative Comprehensive Medication Management for Children and Youth
Children 2019, 6(4), 57; https://doi.org/10.3390/children6040057 - 08 Apr 2019
Cited by 1
Abstract
Almost 30 million babies worldwide are born prematurely or become ill annually and need specialized care to survive. Formalized collaborative practice agreements (CPA) between clinical pharmacists and physicians have been put forward as a means for improving the overall medicating experience in many [...] Read more.
Almost 30 million babies worldwide are born prematurely or become ill annually and need specialized care to survive. Formalized collaborative practice agreements (CPA) between clinical pharmacists and physicians have been put forward as a means for improving the overall medicating experience in many patient populations, including children. This report briefly describes opportunities for collaboration using examples from countries on each continent where CPA is established in professional governance documents and standards. It also provides resources in the form of a toolkit for countries and pharmacist–physician collaborators to authorize and form CPAs to provide comprehensive medication management (CMM) for children and youth with special health care needs (CSHCN). Full article
Open AccessArticle
Description of an Innovative Pediatric Individualized Therapeutics Clinic: Working toward Precision Drug Therapy
Children 2019, 6(2), 35; https://doi.org/10.3390/children6020035 - 25 Feb 2019
Cited by 1
Abstract
The GOLDILOKs® (Genomic and Ontogeny-Linked Dose Individualization and cLinical Optimization for KidS) Clinic aims to provide families and physicians with data to make more informed decisions with regard to pharmacological therapy by using innovative therapy and genomic technologies. The objectives are two-fold: [...] Read more.
The GOLDILOKs® (Genomic and Ontogeny-Linked Dose Individualization and cLinical Optimization for KidS) Clinic aims to provide families and physicians with data to make more informed decisions with regard to pharmacological therapy by using innovative therapy and genomic technologies. The objectives are two-fold: (1) To describe the utility of the GOLDILOKs® Clinic to referring prescribers by evaluating the type of referrals made to the GOLDILOKs® Clinic and (2) to assess the most often utilized technologies (e.g., genotyping) completed to formulate therapy recommendations. Patient data from July 2010 to June 2016 was retrospectively reviewed following Institutional Review Board (IRB) approval. The GOLDILOKs® Clinic evaluated 306 patients and had increases in annual referrals from 14 in 2010–2011 to 84 in 2016–2017. The children that were referred were predominately Caucasian (82%) and male (59%) with an average age of 12.4 ± 5.9 years. Subspecialty versus primary care referrals accounted for 82% and 18% of referrals, respectively. Adverse drug reactions (n = 166) and poor medication response (n = 179) were the major reasons for referral. However, it must be noted that patients could have multiple reasons for referral. Pharmacogenetic results were extensively used to provide guidance for future therapy in patients with medication-related problems. Genotyping of drug metabolizing enzymes and drug target receptors was performed in 221 patients (72.2%). Recommendations were fully accepted by 63% and partially accepted by 22% of internal provider referrals. Full article
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Review

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Open AccessReview
Developing Future Clinical Pharmacy Leaders in the Interprofessional Care of Children with Special Health Care Needs and Medical Complexity (CSHCN-CMC) in a Pediatric Pulmonary Center
Children 2019, 6(12), 135; https://doi.org/10.3390/children6120135 (registering DOI) - 09 Dec 2019
Abstract
The health care needs of children with special health care needs and medical complexity (CSHCN-CMC) are multifaceted and often require the expertise of various disciplines. The medication-related needs of this population can be further complicated with off-label medication use, polypharmacy, and vulnerability to [...] Read more.
The health care needs of children with special health care needs and medical complexity (CSHCN-CMC) are multifaceted and often require the expertise of various disciplines. The medication-related needs of this population can be further complicated with off-label medication use, polypharmacy, and vulnerability to medication errors. Although clinical pharmacists are increasingly becoming a common part of inpatient, pediatric interprofessional patient care teams, their presence remains lacking in the outpatient or ambulatory care realm. Pediatric clinical pharmacists in the ambulatory care setting have the potential to help optimize medication use and safety through collaborative efforts as part of the interprofessional team. Since the late 1960s, Pediatric Pulmonary Centers (PPCs) provide training programs designed to develop interprofessional leaders who will improve the health status of CSHCN-CMC, specifically those with chronic respiratory and sleep-related conditions. The addition of pharmacists not only provides a more comprehensive care model for CSHCN-CMC, it creates an avenue to encourage the career paths of pediatric pharmacists in the ambulatory care setting. Here, we describe the addition of clinical pharmacy as part of an interprofessional patient care team and the development and implementation of a maternal child health (MCH) pharmacy discipline training model designed to mentor future pharmacist leaders in the care of CSHCN-CMC. Full article
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Open AccessReview
Pharmacist Involvement in Population Health Management for a Pediatric Managed Medicaid Accountable Care Organization
Children 2019, 6(7), 82; https://doi.org/10.3390/children6070082 - 04 Jul 2019
Cited by 1
Abstract
Accountable care organizations (ACOs) have emerged as an effective healthcare delivery model for managing quality and cost at a population level. Within ACOs, pharmacists are critical for the delivery of high-value health care, offering patients and health care providers medication-related training, resources, and [...] Read more.
Accountable care organizations (ACOs) have emerged as an effective healthcare delivery model for managing quality and cost at a population level. Within ACOs, pharmacists are critical for the delivery of high-value health care, offering patients and health care providers medication-related training, resources, and guidance that can improve quality of care at lower costs. Partners For Kids (PFK), one of the oldest and largest pediatric ACOs in the country, has successfully leveraged pharmacists to provide population health management and medication management to promote health outcomes for individual patients and the overall population it serves. This review explores how the inclusion of pharmacists in the development and execution of various quality improvement initiatives within PFK has positively impacted outcomes for patients while also lowering overall spend. A catalog of interventions is provided to offer various ways that pharmacists can intersect as providers in the triad of patient/family, payor, and provider. By providing enhanced training and education, on-site guidance, medication management, and population-level data analysis, pharmacists are able to identify and improve inefficiencies in care. Moving forward, ongoing engagement of pharmacists in health care operations will be a necessary feature to maximize health care value. Full article
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