Towards a goal of improving safe patient medication decision-making in pediatric primary care settings, CPCE at CHOP and other collaborating researchers have assembled electronic health record data on more than 1.2 million children from health systems across the US to study patient medication safety and effectiveness. This collaboration has developed novel methods to use electronic health records to look at prescribing practices in pediatric primary care settings and identify disparities and their impact on health and development of young patients.
This team has used this database to conduct both observational comparative effectiveness and prospective observational studies. Results to date have documented:
- low rates of identification and treatment of pediatric hypertension
- high levels of variability in psychotropic medication use across practices
- changing patterns in the use of these medications with labeling and guideline changes
This line of research has also developed new methods for aggregating, cleaning and analyzing large secondary-use datasets derived from EHRs. In a recent publication, CPCE researchers validated methods for imputing race and ethnicity information to facilitate health disparities research.
Funding: National Institute of Health, Federal Maternal and Child Health Bureau
What's Next: The research team is currently investigating primary care drug therapeutics using comparative effectiveness methods in a pediatric electronic health record network.
Please contact Alexander Fiks, MD, MSCE, CPCE associate director, associate medical director of the Pediatric Research Consortium, and an Urban Care pediatrician at CHOP for more information about this line of research.
Patient Medication Safety Published Research
Fiks AG, Grundmeier RW, Margolis B, Bell LM, Steffes J, Massey J, Wasserman RC. Comparative Effectiveness Research Using the Electronic Medical Record: An Emerging Area of Investigation in Pediatric Primary Care. The Journal of Pediatrics, 2012. 160: 719-724.
Fiks AG, Mayne SL, Song L, Steffes J, Liu W, McCarn B, Margolis B, Grimes A, Gotlieb E, Localio R, Ross ME, Grundmeier RW, Wasserman R, Leslie LK. Changing Patterns of Alpha Agonist Use in Children, 2009-2011. Journal of Child and Adolescent Psychopharmacology, 2015. 25(4): 362-367.
Grundmeier RW, Song L, Ramos MJ, Fiks AG, Fremont A, Elliott MN, Wasserman RC, Localio AR. Imputing missing race/ethnicity in pediatric electronic health records: reducing bias with use of US Census location and surname data. Health Serv Res, 2015. 50(4):946-60.