Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?

Polypharmacy among geriatric patients poses significant clinical and economic challenges, including increased risks of adverse drug reactions, cognitive decline, and hospitalizations. While raising physician awareness is necessary, it is insufficient on its own. This narrative review highlights the...

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Main Author: Henry Sutanto
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Archives of Gerontology and Geriatrics Plus
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Online Access:http://www.sciencedirect.com/science/article/pii/S2950307825000669
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author Henry Sutanto
author_facet Henry Sutanto
author_sort Henry Sutanto
collection DOAJ
description Polypharmacy among geriatric patients poses significant clinical and economic challenges, including increased risks of adverse drug reactions, cognitive decline, and hospitalizations. While raising physician awareness is necessary, it is insufficient on its own. This narrative review highlights the importance of comprehensive, evidence-based interventions to optimize medication management. Tools such as the Beers Criteria, STOPP/START guidelines, Anticholinergic Cognitive Burden (ACB) scale, and Drug Burden Index (DBI) are essential for identifying potentially inappropriate medications and reducing medication-related harm. The review underscores the need for structured medication reviews, deprescribing protocols, and individualized care planning. Furthermore, clinical decision support tools (CDSS) enhance prescribing safety by identifying drug-drug interactions and recommending safer alternatives. Systemic reforms—like policy incentives for deprescribing, medication reconciliation programs, and telemedicine-enabled interventions—support continuity of care and improve adherence. Interdisciplinary collaboration, involving pharmacists, nurses, and geriatricians, is critical for effective polypharmacy management. In low- and middle-income countries (LMICs), tailored solutions such as task-shifting, simplified prescribing protocols, and culturally sensitive education are emphasized. Overall, the article advocates for a comprehensive approach that combines clinical tools, systemic strategies, and collaborative care to ensure safer, more effective pharmacotherapy for older adults.
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spelling doaj-art-91c66eaeef49453ea05848ee7429926c2025-08-20T03:15:03ZengElsevierArchives of Gerontology and Geriatrics Plus2950-30782025-09-012310018510.1016/j.aggp.2025.100185Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?Henry Sutanto0Internal Medicine Study Program, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, IndonesiaPolypharmacy among geriatric patients poses significant clinical and economic challenges, including increased risks of adverse drug reactions, cognitive decline, and hospitalizations. While raising physician awareness is necessary, it is insufficient on its own. This narrative review highlights the importance of comprehensive, evidence-based interventions to optimize medication management. Tools such as the Beers Criteria, STOPP/START guidelines, Anticholinergic Cognitive Burden (ACB) scale, and Drug Burden Index (DBI) are essential for identifying potentially inappropriate medications and reducing medication-related harm. The review underscores the need for structured medication reviews, deprescribing protocols, and individualized care planning. Furthermore, clinical decision support tools (CDSS) enhance prescribing safety by identifying drug-drug interactions and recommending safer alternatives. Systemic reforms—like policy incentives for deprescribing, medication reconciliation programs, and telemedicine-enabled interventions—support continuity of care and improve adherence. Interdisciplinary collaboration, involving pharmacists, nurses, and geriatricians, is critical for effective polypharmacy management. In low- and middle-income countries (LMICs), tailored solutions such as task-shifting, simplified prescribing protocols, and culturally sensitive education are emphasized. Overall, the article advocates for a comprehensive approach that combines clinical tools, systemic strategies, and collaborative care to ensure safer, more effective pharmacotherapy for older adults.http://www.sciencedirect.com/science/article/pii/S2950307825000669Geriatric medicinePolypharmacyDrug interactionSenilityGerontology
spellingShingle Henry Sutanto
Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?
Archives of Gerontology and Geriatrics Plus
Geriatric medicine
Polypharmacy
Drug interaction
Senility
Gerontology
title Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?
title_full Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?
title_fullStr Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?
title_full_unstemmed Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?
title_short Tackling polypharmacy in geriatric patients: Is increasing physicians’ awareness adequate?
title_sort tackling polypharmacy in geriatric patients is increasing physicians awareness adequate
topic Geriatric medicine
Polypharmacy
Drug interaction
Senility
Gerontology
url http://www.sciencedirect.com/science/article/pii/S2950307825000669
work_keys_str_mv AT henrysutanto tacklingpolypharmacyingeriatricpatientsisincreasingphysiciansawarenessadequate