Polypharmacy Management in Older Adults
Summary
Polypharmacy is widespread among older adults in the context of multimorbidity and rising therapeutic options. Management strategies aim to balance benefits and risks of multiple concurrent medications, reducing adverse drug reactions, hospitalisations and functional decline. Core approaches include systematic medication review, risk stratification and patient-centred deprescribing. Clinical frameworks emphasise individualised assessment, considering age-related changes in pharmacokinetics and pharmacodynamics, comorbid burden and patient preferences. Interventions range from electronic decision support to multidisciplinary care models involving pharmacists, geriatricians and primary-care teams. Recent advances stress implementation science to translate guidelines into routine practice, with cost-effectiveness and sustainability as central concerns. Global demographic shifts amplify the need for optimised medication regimens across diverse healthcare settings.
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Polypharmacy Management in Older Adults publication trend
The graph below shows the total number of articles in polypharmacy management in older adults across all publications each year (not limited to Nature Index journals).
Technical terms
Polypharmacy: Concurrent use of multiple medications by a patient, often defined numerically (for example, five or more daily agents).
Deprescribing: Systematic process of identifying and discontinuing medicines that are unnecessary or potentially harmful, with the aim of improving patient outcomes.
STOPP/START criteria: A consensus-based screening tool comprising Screening Tool of Older Persons’ Potentially Inappropriate Prescriptions (STOPP) and Screening Tool to Alert to Right Treatment (START), used to guide appropriate prescribing and detect omissions.
Knowledge broker: An individual or team facilitating the translation of evidence-based guidelines into clinical practice through education, coordination and implementation support.
References
- Evidence-based Medication knowledge Brokers in Residential Aged CarE (EMBRACE): protocol for a helix-counterbalanced randomised controlled trial. Implementation Science (2024).
- What is polypharmacy? A systematic review of definitions. BMC Geriatrics (2017).
- STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age and Ageing (2014).
- Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. European Geriatric Medicine (2021).
- Effectiveness of medication review: a systematic review and meta-analysis of randomized controlled trials. BMC Primary Care (2017).
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