NCT05761847

Brief Summary

The purpose of this study is to evaluate whether an intervention called Pediatric Medication Therapy Management (pMTM) improves the identification and management of medication-related problems among children with medical complexity and polypharmacy.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
371

participants targeted

Target at P75+ for not_applicable

Timeline
21mo left

Started Sep 2023

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress60%
Sep 2023Jan 2028

First Submitted

Initial submission to the registry

February 27, 2023

Completed
10 days until next milestone

First Posted

Study publicly available on registry

March 9, 2023

Completed
6 months until next milestone

Study Start

First participant enrolled

September 11, 2023

Completed
4.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2027

Expected
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

January 31, 2028

Last Updated

April 28, 2026

Status Verified

April 1, 2026

Enrollment Period

4.1 years

First QC Date

February 27, 2023

Last Update Submit

April 27, 2026

Conditions

Keywords

Children with Medical ComplexityPolypharmacyMedication Safety

Outcome Measures

Primary Outcomes (1)

  • Medication-Related Problem (MRP) Count

    A MRP is a clearly defined event involving medication therapy that interferes with an optimum outcome for a specific patient, including: inappropriate or unnecessary therapy; suboptimal therapy; undertreated symptom; adverse drug event; major drug-drug interaction; duplication of therapy; or, unclear prescription instruction.

    90 Days

Secondary Outcomes (2)

  • Change in Parent-Reported Outcomes of Symptoms (PRO-Sx) Global Symptom Score

    Baseline and 90 Days

  • Acute Healthcare Visit Count

    90 Days

Study Arms (2)

Usual Care

NO INTERVENTION

The usual care group will receive standard-of-care medication management practices delivered during the course of a routine clinical visit.

Intervention

EXPERIMENTAL

The intervention group will receive the pMTM study intervention before a routine clinical visit.

Other: Pediatric Medication Therapy Management (pMTM)

Interventions

The pMTM intervention is comprised of 3 activities: comprehensive review of the medication regimen; optimization of the medication regimen; and creation of the medication action plan.

Intervention

Eligibility Criteria

Age2 Years - 18 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • years old
  • ≥1 complex chronic condition (CCC)
  • ≥5 current medications (including prescription, as needed, and over-the-counter medications)
  • Receives primary care at Children's Hospital Colorado

You may not qualify if:

  • Non-English speaking
  • Sibling or family member already enrolled in this study

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Children's Hospital Colorado

Aurora, Colorado, 80045, United States

RECRUITING

Related Publications (6)

  • Feinstein JA, Friedman H, Orth LE, Feudtner C, Kempe A, Samay S, Blackmer AB. Complexity of Medication Regimens for Children With Neurological Impairment. JAMA Netw Open. 2021 Aug 2;4(8):e2122818. doi: 10.1001/jamanetworkopen.2021.22818.

    PMID: 34436607BACKGROUND
  • Marquez C, Thompson R, Feinstein JA, Orth LE. Identifying opportunities for pediatric medication therapy management in children with medical complexity. J Am Pharm Assoc (2003). 2022 Sep-Oct;62(5):1587-1595.e3. doi: 10.1016/j.japh.2022.04.005. Epub 2022 Apr 12.

    PMID: 35527209BACKGROUND
  • Feinstein JA, Hall M, Antoon JW, Thomson J, Flores JC, Goodman DM, Cohen E, Azuine R, Agrawal R, Houtrow AJ, DeCourcey DD, Kuo DZ, Coller R, Gaur DS, Berry JG. Chronic Medication Use in Children Insured by Medicaid: A Multistate Retrospective Cohort Study. Pediatrics. 2019 Apr;143(4):e20183397. doi: 10.1542/peds.2018-3397.

    PMID: 30914443BACKGROUND
  • Feinstein JA, Feudtner C, Blackmer AB, Valuck RJ, Fairclough DL, Holstein J, Gregoire L, Samay S, Kempe A. Parent-Reported Symptoms and Medications Used Among Children With Severe Neurological Impairment. JAMA Netw Open. 2020 Dec 1;3(12):e2029082. doi: 10.1001/jamanetworkopen.2020.29082.

    PMID: 33306117BACKGROUND
  • Feinstein JA, Feudtner C, Valuck RJ, Fairclough DL, Holstein JA, Samay S, Kempe A. Identifying Important Clinical Symptoms in Children With Severe Neurological Impairment Using Parent-Reported Outcomes of Symptoms. JAMA Pediatr. 2020 Nov 1;174(11):1114-1117. doi: 10.1001/jamapediatrics.2020.2987.

    PMID: 33044500BACKGROUND
  • Orth LE, Feudtner C, Kempe A, Morris MA, Colborn KL, Gritz RM, Linnebur SA, Begum A, Feinstein JA. A coordinated approach for managing polypharmacy among children with medical complexity: rationale and design of the Pediatric Medication Therapy Management (pMTM) randomized controlled trial. BMC Health Serv Res. 2023 Apr 29;23(1):414. doi: 10.1186/s12913-023-09439-y.

MeSH Terms

Conditions

Medication Adherence

Condition Hierarchy (Ancestors)

Patient CompliancePatient Acceptance of Health CareTreatment Adherence and ComplianceHealth BehaviorBehavior

Study Officials

  • James A Feinstein, MD, MPH

    University of Colorado, Denver

    PRINCIPAL INVESTIGATOR

Central Study Contacts

James A Feinstein, MD, MPH

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Model Details: Hybrid Type 2 Randomized Controlled Trial (RCT)
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 27, 2023

First Posted

March 9, 2023

Study Start

September 11, 2023

Primary Completion (Estimated)

September 30, 2027

Study Completion (Estimated)

January 31, 2028

Last Updated

April 28, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Locations