Pharmacist-Led Interventions in the Management of Polypharmacy: A Systematic Review of Clinical Effectiveness, Prescribing Quality and Patient Safety Outcomes

Authors

DOI:

https://doi.org/10.66636/gmj.v1.i2.a41

Keywords:

Polypharmacy, Pharmacist-led Interventions, Medication Review;, Deprescribing, Patient Safety, Clinical Pharmacy, Potentially Inappropriate Medications, STOPP/START Criteria, Beers Criteria, Medication Safety

Abstract

Polypharmacy represents a growing global healthcare challenge, particularly among elderly populations with multimorbidity. While multiple pharmacological therapies are often clinically justified, inappropriate prescribing increases the risk of adverse drug reactions, hospitalisation, and reduced adherence. Pharmacist-led interventions have emerged as a strategy to optimise pharmacotherapy and improve patient outcomes.

References

1. Masnoon N, Shakib S, Kalisch-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatr. 2017;17(1):230. doi:10.1186/s12877-017-0621-2 DOI: https://doi.org/10.1186/s12877-017-0621-2

2. World Health Organization. Medication Safety in Polypharmacy. Geneva: WHO; 2019. (WHO/UHC/SDS/2019.11). Available from: https://www.who.int/publications/i/item/WHO-UHC-SDS-2019.11

3. Rankin A, Cadogan CA, Patterson SM, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2018;9(9):CD008165. doi:10.1002/14651858.cd008165.pub4 DOI: https://doi.org/10.1002/14651858.CD008165.pub4

4. Feudtner C, Dai D, Hexem KR, et al. Prevalence of polypharmacy exposure among hospitalized children in the United States. Arch Pediatr Adolesc Med. 2012;166(1):9–16. doi:10.1001/archpediatrics.2011.161 DOI: https://doi.org/10.1001/archpediatrics.2011.161

5. O’Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625–32. doi:10.1007/s41999-023-00777-y DOI: https://doi.org/10.1007/s41999-023-00777-y

6. By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052–81. doi:10.1111/jgs.18372 DOI: https://doi.org/10.1111/jgs.18372

7. Kose S. Polypharmacy practice: do pharmacists have a role? J Pharma Care Health Sys. 2016;3:153. doi:10.1186/s40780-016-0061-8 DOI: https://doi.org/10.1186/s40780-016-0061-8

8. Patterson SM, Cadogan CA, Kerse N, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev. 2014;(10):CD008165. doi:10.1002/14651858.CD008165.pub3 DOI: https://doi.org/10.1002/14651858.CD008165.pub3

9. Johansson T, Abuzahra ME, Keller S, et al. Impact of strategies to reduce polypharmacy on clinically relevant endpoints: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016;82(2):532–48. doi:10.1111/bcp.12959 DOI: https://doi.org/10.1111/bcp.12959

10. Cooper JA, Cadogan CA, Patterson SM, et al. Interventions to improve the appropriate use of polypharmacy in older people: a Cochrane systematic review. BMJ Open. 2015;5(12):e009235. doi:10.1136/bmjopen-2015-009235 DOI: https://doi.org/10.1136/bmjopen-2015-009235

11. Page AT, Clifford RM, Potter K, et al. The feasibility and effect of deprescribing in older adults on mortality and health outcomes: a systematic review and meta-analysis. Br J Clin Pharmacol. 2016;82(3):583–623. doi:10.1111/bcp.12975 DOI: https://doi.org/10.1111/bcp.12975

12. Huiskes VJ, Burger DM, van den Ende CH, van den Bemt BJ. Effectiveness of medication review: a systematic review and meta-analysis of randomized controlled trials. BMC Fam Pract. 2017;18(1):5. doi:10.1186/s12875-016-0577-x DOI: https://doi.org/10.1186/s12875-016-0577-x

13. Jokanovic N, Tan EC, Sudhakaran S, et al. Pharmacist-led medication review in community settings: an overview of systematic reviews. Res Social Adm Pharm. 2017;13(4):661–85. doi:10.1016/j.sapharm.2016.08.005 DOI: https://doi.org/10.1016/j.sapharm.2016.08.005

14. O’Mahony D, O’Sullivan D, Byrne S, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–8. doi:10.1093/ageing/afu145 DOI: https://doi.org/10.1093/ageing/afu145

15. Curtin D, Gallagher P, O’Mahony D. Deprescribing in older people approaching end of life: a randomized controlled trial using STOPPFrail criteria. J Am Geriatr Soc. 2020;68(4):762–69. doi:10.1111/jgs.16278 DOI: https://doi.org/10.1111/jgs.16278

16. Scott IA, Hilmer SN, Reeve E, et al. Reducing inappropriate polypharmacy: the process of deprescribing. JAMA Intern Med. 2015;175(5):827–34. doi:10.1001/jamainternmed.2015.0324 DOI: https://doi.org/10.1001/jamainternmed.2015.0324

17. Kaur S, Mitchell G, Vitetta L, Roberts MS. Interventions that can reduce inappropriate prescribing in the elderly: a systematic review. Drugs Aging. 2009;26(12):1013–28. doi:10.2165/11318890-000000000-00000 DOI: https://doi.org/10.2165/11318890-000000000-00000

18. Clyne B, Cooper JA, Hughes CM, et al. A process evaluation of a cluster randomised trial to reduce potentially inappropriate prescribing in older people in primary care. Trials. 2016;17(1):402. doi:10.1186/s13063-016-1513-z DOI: https://doi.org/10.1186/s13063-016-1513-z

19. Reeve E, Jordan V, Thompson W, et al. Withdrawal of antihypertensive drugs in older people. Cochrane Database Syst Rev. 2020;6(6):CD012572. doi:10.1002/14651858.cd012572.pub2 DOI: https://doi.org/10.1002/14651858.CD012572.pub2

20. Thillainadesan J, Gnjidic D, Green S, Hilmer SN. Impact of deprescribing interventions in older hospitalised patients on prescribing and clinical outcomes: a systematic review of randomised trials. Drugs Aging. 2018;35(4):303–19. doi:10.1007/s40266-018-0536-4 DOI: https://doi.org/10.1007/s40266-018-0536-4

21. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med. 2021;12(3):443–452. doi:10.1007/s41999-021-00479-3 DOI: https://doi.org/10.1007/s41999-021-00479-3

22. Dreischulte T, van den Bemt B, Steurbaut S, et al. European Society of Clinical Pharmacy definition of the term “clinical pharmacy” and its relationship to pharmaceutical care: a position paper. Int J Clin Pharm. 2022;44(4):837–842. doi:10.1007/s11096-022-01422-7 DOI: https://doi.org/10.1007/s11096-022-01422-7

23. Ailabouni NJ, Nishtala PS, Mangin D, Tordoff JM. Challenges and enablers of deprescribing: a general practitioner perspective. PLoS One. 2016;11(4):e0151066. doi:10.1371/journal.pone.0151066 DOI: https://doi.org/10.1371/journal.pone.0151066

24. Reeve E, To J, Hendrix I, et al. Patient barriers to and enablers of deprescribing: a systematic review. Drugs Aging. 2013;30(10):793–807. doi:10.1007/s40266-013-0106-8 DOI: https://doi.org/10.1007/s40266-013-0106-8

25. Doherty AJ, Boland P, Reed J, et al. Barriers and facilitators to deprescribing in primary care: a systematic review and meta-ethnography. BJGP Open. 2021;5(3):BJGP.2020.0189. doi:10.3399/bjgpopen20x101096 DOI: https://doi.org/10.3399/bjgpopen20X101096

26. Zazzara MB, Palmer K, Vetrano DL, et al. Adverse drug reactions in older adults: a narrative review of the literature. Eur Geriatr Med. 2021;12(3):463–471. doi:10.1007/s41999-021-00481-9 DOI: https://doi.org/10.1007/s41999-021-00481-9

27. Halli-Tierney AD, Scarbrough C, Carroll D. Polypharmacy: evaluating risks and deprescribing. Am Fam Physician. 2019;100(1):32–8. Available from: https://www.aafp.org/pubs/afp/issues/2019/0701/p32.html

Cover of the Georgian Medical Journal (GMJ), Volume 1, Issue 2 (2026), titled “Health Systems Performance and Quality of Care: Measurement, Improvement, and Outcomes,” with a blue world map background representing global health connectivity. Includes the themes “Quality, Safety, Results” and the publisher Public Health Institute of Georgia.

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Published

05/09/2026

How to Cite

Alavidze, N., Javakhia, M., Abuladze, N., Gabunia, K., Sulashvili, N., & Chubinidze, N. (2026). Pharmacist-Led Interventions in the Management of Polypharmacy: A Systematic Review of Clinical Effectiveness, Prescribing Quality and Patient Safety Outcomes. Georgian Medical Journal, 1(2), 1–16. https://doi.org/10.66636/gmj.v1.i2.a41

Issue

Vol. 1 No. 2 (2026): Health Systems Performance and Quality of Care

Section

Systematic Reviews & Analysis

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Copyright (c) 2026 Nato Alavidze, Maka Javakhia, Nino Abuladze, Ketevani Gabunia, Nodar Sulashvili, Natia Chubinidze

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