Integration of a Pharmacist in a Pediatric Medical Home for Children with Medical Complexity

Integration of a Pharmacist in a Pediatric Medical Home for Children with Medical Complexity

Alannah K. Yoder, Children's Mercy Hospital
Richard K. Ogden Jr., Children's Mercy Hospital
Ingrid A. Larson, Children's Mercy Hospital
Emily K. Goodwin, Children's Mercy Hospital



Children with medical complexity require unique care, specialized attention, and a dedicated team to meet the needs of the patient & caregivers. Drug-therapy related problems in complex, chronic conditions influence financial, institutional, and patient outcomes. The addition of a pharmacist allows for collaboration and delivery of comprehensive medication management in order to provide value-added medication services to optimize complex therapeutic regimens and patient outcomes through evidence-based practice, medication adherence, medication use coordination, and medication safety processes.


Our program provides a pediatric medical home for hundreds of children with medical complexity. Families are cared for by a comprehensive medical team, including a clinical pharmacist. The pharmacist is available for all appointments and meets with patients and caregivers at the beginning of clinic visits. The pharmacist’s initiative to improve patient care is provided through multiple services which include: (1) comprehensive medication reconciliation through history provided by caregiver, outpatient pharmacy review, and chart review of specialty teams; (2) adverse drug assessment; (3) systemic drug-utilization review of each medication (drug-disease contraindication, drug-drug interaction, drug-patient precaution, dosing, duration of drug treatment, over and/or underutilization, drug dosage for modification, adherence concerns, and determination if additional monitoring is warranted); (4) patient education and development of personal, family-friendly medication lists; and (5) coordination of care between inpatient admissions, specialty/consulting services, home healthcare, and prior authorization needs.


The integration of a pharmacist in a pediatric medical home for children with medical complexity and childhood-onset disabilities allows for innovation and interdisciplinary collaboration to provide comprehensive medication management. Incorporation of family education and tangible medication plans promotes safe and consistent medication practices. Further studies describing the qualitative and quantitative impact on patient outcomes will be conducted at our institution.