Michael C. Tracy, Joseph M. Collaco, Gangaram Akangire, Nicolas A. Bamat, Manvi Bansai, Sara K. Dawson, Lystra P. Hayden, Winston M. Manimtim, Antonia P. Popova, Demet Toprak, Sharon A. McGrath-Morrow, Paul E. Moore
Stanford University. Johns Hopkins University. Children’s Mercy Hospital. University of Missouri Kansas City School of Medicine. Children’s Hospital of Philadelphia and University of Pennsylvania. Children’s Hospital of Los Angeles. Medical College of Wisconsin. Boston Children’s Hospital and Harvard Medical School. University of Michigan Medical School. University of Washington. Vanderbilt University and Vanderbilt University Medical Center.
United States
Pediatric Pulmonology
Pediatr Pulmonol 2026; 61:
DOI: 10.1002/ppul.71622
Abstract
Objective: To understand the prescribing patterns and clinical practices of providers for infants and children with bronchopulmonary dysplasia (BPD) in the outpatient clinic setting.
Methods: We conducted a survey of BPD Collaborative programs from diverse geographic areas inside and outside the United States from January 2025 through March 2025.
Results: Twenty-nine of 45 centers in the BPD Collaborative completed the survey, including 27 from the U.S. and 2 from other countries. The majority of respondents identified as pediatric pulmonologists (72.4%). Most healthcare providers endorsed that patient symptomatology was a major driver of decision making (79.3%) and greater BPD severity correlated with a higher likelihood of medication use. Beta-agonists and inhaled corticosteroids (ICS) were the most commonly prescribed medications across all levels of severity. While prescriptions for pulmonary hypertension (PH) medications and diuretics decreased with age, use of inhaled medications persisted or increased in frequency. Challenges obtaining medications included insurance authorization issues (69.0%) and medication costs (51.7%). Adherence to therapy was a concern for over half of BPD programs.
Conclusions: Despite limited evidence for outpatient pharmacotherapy in children with BPD, we identified consistent cross-center practice patterns. Providers reported that while the utilization of therapies was associated with higher BPD severity and greater respiratory support, medications were prescribed across the spectrum of disease severity. Treatment practices varied by age group and were often hindered by common barriers to accessing medications. These findings underscore the need to revise clinical guidelines to enhance long-term outpatient pharmacotherapy for infants and children with BPD.
Category
Class III. Pulmonary Hypertension Associated with Lung Disease
Medical Therapy. Efficacy or Lack of Efficacy
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No