# Improving medication safety for medically complex children with mHealth across caregiving networks

> **NIH AHRQ R18** · UNIVERSITY OF WISCONSIN-MADISON · 2022 · $499,999

## Abstract

PROJECT SUMMARY
Children with medical complexity (CMC) are uniquely vulnerable to medication errors and adverse drug events
because of their extreme polypharmacy, underlying medical fragility, and reliance on complicated medication
schedules and routes. CMC have 5 times higher odds of an adverse drug event leading to an Emergency
Department (ED) visit than other children. Over 1 of 50 CMC ED visits are due to adverse drug events, and
38% of CMC ED visits for adverse drug events result in hospital admission. Having accurate knowledge to
accurately give high-risk medications is an absolute requirement for safe medication management. Prior work
observed that medication administration accuracy, i.e., knowing indication, formulation, dose, frequency, and
route of administration, was successfully described by fewer than half of CMC caregivers. Low medication
administration accuracy leads to adverse drug events, including potentially preventable hospitalizations,
emergency department visits, and morbidity. Currently, no tools exist to support families of CMC to ensure high
medication administration accuracy across their network of “secondary” caregivers involved in CMC daily care
(e.g., family, in-home care professionals, school caregivers, etc.). To address these critical unmet needs, we
will create a mobile health (mhealth) platform, Medication Safety @HOME (MedS@HOME) to improve CMC
medication safety by supporting standardized medication management across the caregiving network. We
anticipate that MedS@HOME will increase medication administration accuracy and reduce medication-related
adverse events, and ultimately improve chronic care management through the creation and promotion of
standardized medication management practices across the caregiving network. To achieve this goal, we
propose to conduct the following aims: 1) Design the MedS@HOME intervention through participatory co-
design with stakeholders in a parallel design process with three design teams: one with primary CMC
caregivers, one with secondary caregivers, and one with experts in medication safety and CMC clinical care; 2)
Evaluate the effectiveness of MedS@HOME on medication administration accuracy of high-risk medications
(e.g., antiepileptic drugs, opioids) in a randomized controlled trial, testing the hypothesis that medication
administration accuracy is improved for primary and secondary caregivers with use of MedS@HOME.
Completion of the aims will result in a scalable mhealth intervention that improves medication safety for CMC
across the caregiving network. MedS@HOME, when perfected, can improve medication safety and chronic
care management across the wide range of populations that depend on caregiving networks.

## Key facts

- **NIH application ID:** 10411594
- **Project number:** 1R18HS028409-01A1
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Ryan J Coller
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $499,999
- **Award type:** 1
- **Project period:** 2022-05-02 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10411594

## Citation

> US National Institutes of Health, RePORTER application 10411594, Improving medication safety for medically complex children with mHealth across caregiving networks (1R18HS028409-01A1). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10411594. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*