Polypharmacy and Medication Management in Older Adults

Kim, Jennifer; Parish, Abby Luck

doi:10.1016/j.cnur.2017.04.007

Cited by 245Pharmaceutical Practices and Patient OutcomesPharmacy and Medical PracticesChronic Disease Management Strategies

Polypharmacy and Medication Management in Older Adults

Kim, Jennifer, Parish, Abby Luck·2017·Nursing Clinics of North America

DOI 10.1016/j.cnur.2017.04.007

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Abstract

Polypharmacy in older adults is a global problem that has recently worsened. Approximately 30% of adults aged 65 years and older in developed countries take 5 or more medications. Although prescribed and over-the-counter medications may improve a wide range of health problems, they also may cause or contribute to harm, especially in older adults. Polypharmacy in older adults is associated with worsening of geriatric syndromes and adverse drug events. Given the risks and burdens of polypharmacy and potentially inappropriate medications, nurses must use patient-centered approaches and nonpharmacologic strategies to treat common symptoms and to optimize patient function and quality of life.

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Strategies to manage polypharmacy and potentially inappropriate medications in older adults often overlook the role of exercise prescription.
“Strategies to manage polypharmacy and potentially inappropriate medications (PIMs) in older adults often overlook the role of exercise prescription [538,539].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [538]

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The Relationship of Continuity of Care, Polypharmacy and Medication Appropriateness: A Systematic Review of Observational Studies
Lampe, D., Grosser, J., Gensorowsky, D., Witte, J., Muth, C., van den Akker, M., Dinh, T. S., & Greiner, W. (2023) · Drugs & Aging · doi:10.1007/s40266-023-01022-8 · Cited by 27 · see citing works
“Suboptimal care transitions and a lack of collaboration between health care providers (e.g., physicians) have been identified as major problems impeding optimal medication management processes and patient safety [20–23].”
Integrating exercise and medication management in geriatric care: a holistic strategy to enhance health outcomes and reduce polypharmacy
Izquierdo, M., Ramírez‐Vélez, R., & Singh, M. F. (2025) · The Lancet Healthy Longevity · doi:10.1016/j.lanhl.2025.100763 · Cited by 29 · see citing works
Clinical outcomes of geriatric patients with COVID-19: review of one-year data
Avcı, G. U., Kanat, B. B., Suzan, V., Can, G., Korkmazer, B., Karaali, R., Tabak, F., Börekçi, Ş., Aygün, G., Yavuzer, H., et al. (2022) · Aging Clinical and Experimental Research · doi:10.1007/s40520-021-02047-y · Cited by 24 · see citing works
“The use of five or more drugs on admission was considered polypharmacy [7, 8].”
Background
Silent Dangers in Elderly Pharmacotherapy: The Interplay of Polypharmacy, Multimorbidity, and Drug Interactions
Ngcobo, N. N. (2025) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.70283 · Cited by 22 · see citing works
“The World Health Organization (WHO) acknowledges this as a significant issue, though international data comparison remains challenging due to varying healthcare systems [9, 109].”
Prevalence and clinical implications of polypharmacy and potentially inappropriate medication in elderly patients with heart failure: results of six months' follow-up
Li, M., Wei, N., Shi, H., Jing, X.-J., Kan, X.-H., Gao, H.-Q., & Xiao, Y.-L. (2023) · 老年心脏病学杂志：英文版 · doi:10.26599/1671-5411.2023.07.002 · Cited by 22 · see citing works
Association of polypharmacy with occurrence of loneliness and social isolation among older adults
Svensson, M., Ekström, H., Elmståhl, S., & Rosso, A. (2023) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2023.105158 · Cited by 22 · see citing works
Polifarmácia, medicamentos potencialmente inapropriados e a vulnerabilidade de pessoas idosas
de Andrade, R. C., dos Santos, M. M., Ribeiro, E. E., dos Santos, J. D. O., Campos, H. L. M., & de Leon, E. B. (2024) · Revista Brasileira de Geriatria e Gerontologia · doi:10.1590/1981-22562024027.230191.pt · Cited by 17 · see citing works
“Diante disso se faz necessário analisar prejuízos e benefícios das prescrições de medicamentos e a repercussão que os MPI têm sobre a saúde da pessoa idosa 26 .”
Background
Development of an explicit tool assessing potentially inappropriate medication use in Hong Kong elder patients
Zhang, H., Wong, E. L., Yeoh, E., & Ma, B. H. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02024-0 · Cited by 17 · see citing works
Dose‐dependent association between xerostomia and number of medications among older adults
Storbeck, T., Qian, F., Marek, C. L., Caplan, D. J., & Marchini, L. (2021) · Special Care in Dentistry · doi:10.1111/scd.12662 · Cited by 17 · see citing works
Clinical pattern and drug-related problems among colorectal cancer patients at oncology center in Ethiopia: A hospital-based study
Kefale, B., Engidaw, M. T., Tesfa, D., Yazie, T. S., Molla, M., & Yismaw, M. B. (2022) · SAGE Open Medicine · doi:10.1177/20503121221131691 · Cited by 17 · see citing works
The Relationship Between a Mediterranean Diet and Frailty in Older Adults: NHANES 2007–2017
Gross, D. C., Dahringer, J. C., Bramblett, P. N., Sun, C., Spangler, H., Lynch, D. H., & Batsis, J. A. (2025) · Nutrients · doi:10.3390/nu17020326 · Cited by 16 · see citing works
“Self-reported polypharmacy, taking five or more medications, was included because of its relationship with an increased risk of geriatric syndromes such as frailty and falls [23].”
Preoperative Deprescribing for Medical Optimization of Older Adults Undergoing Surgery: A Systematic Review
Lee, J. W., Li, M., Boyd, C. M., Green, A. R., & Szanton, S. L. (2021) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2021.11.005 · Cited by 16 · see citing works
Disclosure of Complementary and Alternative Medicine Use Among Older Adults: A Cross-Sectional Study
Golden, J., Kenyon‐Pesce, L., Robison, J. T., Grady, J. J., & Guerrera, M. P. (2023) · Gerontology and Geriatric Medicine · doi:10.1177/23337214231179839 · Cited by 17 · see citing works
“This growing trend of CAM use may be of particular importance in older patients given the prevalence of chronic illness and polypharmacy in this population (Kim & Parish, 2017; National Council on Aging, 2018).”
Background
Prospective association between depressive symptoms and stroke risk among middle-aged and older Chinese
Cui, Y., Zhu, C., Lian, Z., Han, X., Xiang, Q., Liu, Z., & Zhou, Y. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03492-9 · Cited by 15 · see citing works
Nurses’ Experiences Concerning Older Adults with Polypharmacy: A Meta-Synthesis of Qualitative Findings
Cheng, C., Yu, H., & Wang, Q. (2023) · Healthcare · doi:10.3390/healthcare11030334 · Cited by 15 · see citing works
“Nurses play an important role in helping to identify people with polypharmacy and facilitating risk reduction [9].”
Background
Sternal fixation for isolated traumatic sternal fractures improves pain and upper extremity range of motion
Bauman, Z. M., Yanala, U., Waibel, B. H., Malhotra, G. K., Cemaj, S., Evans, C. H., & Schlitzkus, L. L. (2021) · European Journal of Trauma and Emergency Surgery · doi:10.1007/s00068-020-01568-x · Cited by 14 · see citing works
Lifestyle or pharmacotherapy in cardio-metabolic disease prevention
Seidu, B. S., Osman, H., & Seidu, S. (2023) · Therapeutic Advances in Cardiovascular Disease · doi:10.1177/17539447231177175 · Cited by 14 · see citing works
Smart Elderly Healthcare Services in Industry 5.0: A Survey of Key Enabling Technologies and Future Trends
Wang, X., Huang, L., Wang, D., Liu, L., & Guo, P. (2025) · IEEE Access · doi:10.1109/access.2025.3596694 · Cited by 15 · see citing works
Clinical characteristics and outcomes of polypharmacy in chronic obstructive pulmonary disease patients: A cross‐sectional study from Crete, Greece
Ierodiakonou, D., Theodorou, E., Sifaki-Pistolla, D. I., Bouloukaki, I., Antonopoulou, M., Poulorinakis, I., Tsakountakis, N., Voltiraki, F., Chliveros, K., & Tsiligianni, I. (2021) · The Clinical Respiratory Journal · doi:10.1111/crj.13434 · Cited by 13 · see citing works
Medication Deprescribing in Patients Receiving Hemodialysis: A Prospective Controlled Quality Improvement Study
Bortolussi‐Courval, É., Podymow, T., Battistella, M., Trinh, E., Mavrakanas, T. A., McCarthy, L. M., Moryousef, J., Hanula, R., Huon, J., Suri, R. S., et al. (2024) · Kidney Medicine · doi:10.1016/j.xkme.2024.100810 · Cited by 13 · see citing works
Polypharmacy in Type 2 Diabetes: Appropriate or Cause for Concern?
Saeed, Z. I., Ostrominski, J. W., & Aroda, V. R. (2024) · Diabetes Care · doi:10.2337/dci24-0035 · Cited by 14 · see citing works
Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
Christopher, C. M., Bhuvan, K. C., Blebil, A. Q., Alex, D., Ibrahim, M. I. M., Ismail, N., & Alrasheedy, A. A. (2021) · Healthcare · doi:10.3390/healthcare9111577 · Cited by 13 · see citing works
Factors related to excessive polypharmacy (≥15 medications) in an outpatient population from Colombia
Castro‐Rodríguez, A., Machado‐Duque, M. E., Gaviria‐Mendoza, A., Medina-Morales, D. A., Tatiana, Á.-V., & Machado‐Alba, J. E. (2018) · International Journal of Clinical Practice · doi:10.1111/ijcp.13278 · Cited by 13 · see citing works
Prevalence of non-communicable chronic diseases: arterial hypertension, diabetes mellitus, and associated risk factors in long-lived elderly people
da Silva, A. M., do Carmo, A. S., Alves, V. P., & de Carvalho, L. S. F. (2023) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2022-0592 · Cited by 20 · see citing works
“hypnotics, sedatives, anxiolytics, antipsychotics, and anti-ulcer agents) (23,38-39).”
Background
Consistency between anticholinergic burden scales in the elderly with fractures
Valladales‐Restrepo, L. F., Lengua, M. D., Castro-Osorio, E. E., & Machado‐Alba, J. E. (2020) · PLoS ONE · doi:10.1371/journal.pone.0228532 · Cited by 12 · see citing works
“Polypharmacy is associated with the development and worsening of geriatric syndromes, including falls [2] and is involved in the increase in adverse drug reactions (ADR), hospitalizations, complexity of care, morbidity and mortality [3].”
Background
Combating Polypharmacy Through Deprescribing Potentially Inappropriate Medications
Chou, J., Tong, M., & Brandt, N. (2019) · Journal of Gerontological Nursing · doi:10.3928/00989134-20190102-01 · Cited by 12 · see citing works
Polypharmacy and Related Factors in Geriatric Outpatients
Küçükdağlı, P. (2019) · European Journal of Geriatrics and Gerontology · doi:10.4274/ejgg.galenos.2019.144 · Cited by 12 · see citing works
“World Health Organization defined adverse drug events as ‘‘Unintended and undesired effects of a medication at a normal dose’’ and classified into five categories as adverse drug reaction, medication error, therapeutic failure, drug withdrawal and overdose (7-9).”
Drug-induced olfactory and gustatory dysfunction: Analysis of FDA adverse events reporting system
Debbaneh, P. M., McKinnon, L., Haidari, M., & Liang, J. Z. (2023) · Auris Nasus Larynx · doi:10.1016/j.anl.2022.12.012 · Cited by 11 · see citing works
Recent Updates on Risk and Management Plans Associated with Polypharmacy in Older Population
Alshanberi, A. M. (2022) · Geriatrics · doi:10.3390/geriatrics7050097 · Cited by 12 · see citing works
Dificuldades no uso de medicamentos por idosos acompanhados em uma coorte do Sul do Brasil
Guttier, M. C., Silveira, M. P. T., Tavares, N. U. L., Krause, M. C., Bielemann, R. M., González, M. C., Tomasi, E., Demarco, F. F., & Bertoldi, A. D. (2023) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720230020.2 · Cited by 11 · see citing works
“Nenhum 147 (12,8) 30,7 (26,6–38,8) 5,5 (3,2–9,2) 3,0 (1,6–5,4)”
Polypharmacy Is Significantly and Positively Associated with the Frailty Status Assessed Using the 5-Item FRAIL Scale, Cardiovascular Health Phenotypic Classification of Frailty Index, and Study of Osteoporotic Fractures Scale
Hung, C.-D., Yang, C., Lee, C., Hu, S. C., Chen, S., Hung, C., Chuang, H., Chen, C., & Kuo, C. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10194413 · Cited by 10 · see citing works
Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan
Barakat, M. M., Nassar, R. I., Gharaibeh, L. F., Thiab, S. H., & Nashwan, A. J. (2024) · Medical Principles and Practice · doi:10.1159/000541009 · Cited by 10 · see citing works
Understanding constipation as a geriatric syndrome
Cheever, C. R., Shams, R. B., Willingham, K. R., Sim, H., Cook, L. M., Ahmidouch, M. Y., Scholand, K. E., & Wilson, L. A. (2024) · Geriatric Nursing · doi:10.1016/j.gerinurse.2024.12.012 · Cited by 10 · see citing works
Implementation of interprofessional quality circles on deprescribing in Swiss nursing homes: an observational study
Mena, S., Moullin, J. C., Schneider, M. P., & Niquille, A. (2023) · BMC Geriatrics · doi:10.1186/s12877-023-04335-w · Cited by 10 · see citing works
“Both are a concern due to their association with adverse effects such as falls or cognitive impairment [3– 6].”
Background
Exploring non-covalent interactions between caffeine and ascorbic acid: their significance in the physical chemistry of drug efficacy
Abraham, A. B., Alzahrani, A. Y. A., & Thomas, R. (2023) · Zeitschrift für Physikalische Chemie · doi:10.1515/zpch-2023-0390 · Cited by 9 · see citing works
Polypharmacy, potentially inappropriate medications, and the vulnerability of older adults
de Andrade, R. C., dos Santos, M. M., Ribeiro, E. E., dos Santos, J. D. O., Campos, H. L. M., & de Leon, E. B. (2024) · Revista Brasileira de Geriatria e Gerontologia · doi:10.1590/1981-22562024027.230191.en · Cited by 9 · see citing works
“Therefore, it is necessary to analyze the harms and benefits of medication prescriptions and the impact that potentially inappropriate medications (PIM) have on the health of older adults 26 .”
Background
Identifying older adults at increased risk of medication-related readmission to hospital within 30 days of discharge: development and validation of a risk assessment tool
Glans, M., Kempen, T. G. H., Jakobsson, U., Ekstam, A. K., Bondesson, Å., & Midlöv, P. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-070559 · Cited by 9 · see citing works
“Emergency admission, as opposed to planned admission, has been indicated as a risk factor for 30-day readmission in several studies, including ours, 10 22 and the factor is included in both the HOSPITAL Score 27 and the LACE Index.”
Practice and Policy/Research Implications of Deprescribing on Medication Use and Safety in Older Adults
Brandt, N., Simoni, J. M., & Sharma, K. (2018) · Public Policy & Aging Report · doi:10.1093/ppar/pry041 · Cited by 9 · see citing works
Oriental herbal medicine for insomnia in the elderly with hypertension
Kwon, C., Lee, B., Chung, S.-Y., Kim, J. W., & Kim, S.-H. (2018) · Medicine · doi:10.1097/md.0000000000012200 · Cited by 9 · see citing works
“More importantly, the issue of polypharmacy in the elderly population was highlighted recently.([23]) Polypharmacy is described as taking ≥5 medications daily.”
BackgroundSelf-citation
Polypharmacy and associated factors among patients with type two diabetes mellitus with comorbidity: a multicenter cross-sectional study in Northwest Ethiopia
Tamene, F. B., Zeleke, T. K., Desalew, A. F., Tarekegn, G. Y., Sendekie, A. K., Tafere, S. M., Kiflu, M., Moges, T. A., Dagnew, F. N., & Wondm, S. A. (2025) · BMC Endocrine Disorders · doi:10.1186/s12902-025-02011-1 · Cited by 8 · see citing works
“The use of five or more medications is the most prevalent definition of poly-pharmacy, which has historically been linked to harmful consequences despite these differences and it’s estimated prevalence ranges from 57 to 84% [8, 9].”
Vitamin D and depression in older adults: lessons learned from observational and clinical studies
Ceolin, G., Antunes, L. D. C., Moretti, M., Rieger, D. K., & Moreira, J. D. (2022) · Nutrition Research Reviews · doi:10.1017/s0954422422000026 · Cited by 8 · see citing works
Research status and hotspots of medication safety in older adults: A bibliometric analysis
Xie, C., Gu, Y., Wang, Y., Ni, F., & Li, Y. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2022.967227 · Cited by 8 · see citing works
“Prevention of damage due to medication mismanagement is a growing challenge in clinical practice, especially for older adults who are subject to chronic care and the prescription of moremedications (6, 7).”
Background
Association between polypharmacy and chronic kidney disease among community-dwelling older people: a longitudinal study in southern China
Zhang, B., Wang, J., Liu, N., Liu, W., Xi, R., & Wang, P. (2024) · BMC Nephrology · doi:10.1186/s12882-024-03606-x · Cited by 8 · see citing works
“Therefore, medical staff should pay attention to the possibility that elderly patients may experience more diverse reactions when taking multiple medications [37].”
Background
Downregulated expression of organic anion transporting polypeptide (Oatp) 2b1 in the small intestine of rats with acute kidney injury
Takeda, F., Oda, M., Terasaki, M., Kubota, A., Asada, K., Ichimura, Y., Kojima, H., & Saitoh, H. (2021) · Drug Metabolism and Pharmacokinetics · doi:10.1016/j.dmpk.2021.100411 · Cited by 8 · see citing works
Prevalence and determinants of potentially inappropriate medication use in Hong Kong older patients: a cross-sectional study
Zhang, H., Wong, E. L., Wong, S. Y. S., Chau, P. Y., Yip, B. H. K., Chung, R. Y., Lee, E. K. P., Lai, F. T. T., & Yeoh, E. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-051527 · Cited by 8 · see citing works
Association of Sonographic Sarcopenia and Falls in Older Adults Presenting to the Emergency Department
Wongtangman, T., Thatphet, P., Shokoohi, H., McFadden, K., Ma, I. W. Y., Saud, A. A. A., Vivian, R., Hines, R., Gullikson, J., Morone, C. C., et al. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12041251 · Cited by 8 · see citing works
“Although the term of polypharmacy does not have clear-cut definition [37] following multiple studies, we defined polypharmacy as using 5 or more medications [38,39].”
Air pollution exposure is associated with rhinitis in older US adults via specific immune mechanisms
Scussiatto, H. O., Wroblewski, K., Pagel, K. L., Schumm, L. P., McClintock, M. K., Ramanathan, M., Suh, H. H., & Pinto, J. M. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23225 · Cited by 8 · see citing works
“42,43 Our outcomes were robust to the addition of age, sex, race/ethnicity, education, cigarette smoking, and BMI.”
Background
Interventions to optimize prescribing for older people in care homes
Neville, C. C. (2019) · International Journal of Nursing Practice · doi:10.1111/ijn.12763 · Cited by 7 · see citing works
Access to non-prescription medicines via vending machines: key considerations to help transfer the self-care concept to the next generation while managing safety risks
Jairoun, A. A., Al‐Hemyari, S. S., Shahwan, M. J., El‐Dahiyat, F., Jairoun, M., Godman, B., Kurdi, A. B., & Zyoud, S. H. (2022) · Journal of Pharmaceutical Health Services Research · doi:10.1093/jphsr/rmac044 · Cited by 7 · see citing works
Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults
Andrade, A., Nascimento, T., Cabrita, C., Leitão, H. S., & Pinto, E. A. M. (2024) · Healthcare · doi:10.3390/healthcare12131275 · Cited by 7 · see citing works
“Thus, individual needs, pharmacokinetic and pharmacodynamic changes, polymedication, and multimorbidity are risk factors that should be considered in pharmacotherapeutic analyses in this population [19].”
Background
Evolution of the roles of family physicians through collaboration with rehabilitation therapists in rural community hospitals: a grounded theory approach
Ohta, R., Yoshioka, K., & Sano, C. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02540-z · Cited by 7 · see citing works
“Admitted older patients tend to have multimorbid conditions requiring polypharmacy, and they can develop various medical problems [14]; therefore, organ-specific specialists may be unable to effectively manage such patients [2].”
Background
Tools supporting polypharmacy management in Italy: Factors determining digital technologies' intention to use in clinical practice
Catrini, E., Ferrario, L. B., Mazzone, A., Varalli, L., Gatti, F., Cannavacciuolo, L., Ponsiglione, C., & Foglia, E. (2022) · Health Science Reports · doi:10.1002/hsr2.647 · Cited by 6 · see citing works
Drug-related problems and risk factors related to unplanned hospital readmission among cancer patients in Belgium
Koubaity, M., Lechon, A.-S., Amighi, K., Nuffelen, M. V., Moreau, M., Meert, A., & Vriese, C. D. (2021) · Supportive Care in Cancer · doi:10.1007/s00520-020-05916-w · Cited by 7 · see citing works
“Polypharmacywas the last risk factor leading to a readmission [12, 13].”
Background
Downregulated expression of intestinal P-glycoprotein in rats with cisplatin-induced acute kidney injury causes amplification of its transport capacity to maintain “gatekeeper” function
Takeda, F., Oda, M., Terasaki, M., Ichimura, Y., Kojima, H., & Saitoh, H. (2021) · Toxicology and Applied Pharmacology · doi:10.1016/j.taap.2021.115570 · Cited by 7 · see citing works
Health care professionals' perspectives on medication safety among older migrants with cognitive impairment exposed to polypharmacy – A qualitative explorative study
Lynnerup, C., Rossing, C., Sodemann, M., Ryg, J., Pottegård, A., & Nielsen, D. S. (2022) · Exploratory Research in Clinical and Social Pharmacy · doi:10.1016/j.rcsop.2022.100128 · Cited by 6 · see citing works
Changes in Polypharmacy and Psychotropic Medication Use After Diagnosis of Major Neurocognitive Disorders
Maltais, A., Simard, M., Vedel, I., & Sirois, C. (2022) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000513 · Cited by 6 · see citing works
“(3) A claim for a medication to treat MNCD in the pharmaceutical services database.”
Background
Polimedicação em Idosos Submetidos a Tratamento Oncológico
Alves, B. L. P., da Silva, V. G. N., Caetano, I. B. M. O. S., Livinalli, A., & Cruz, M. L. (2020) · Revista Brasileira de Cancerologia · doi:10.32635/2176-9745.rbc.2019v65n4.379 · Cited by 6 · see citing works
Over-The-Counter Remedies in Older Adults
Safari, D., DeMarco, E. C., Scanlon, L., & Grossberg, G. T. (2021) · Clinics in Geriatric Medicine · doi:10.1016/j.cger.2021.07.005 · Cited by 6 · see citing works
Shared decision-making practices and patient values in pharmacist outpatient care for rheumatic disease: A multiple correspondence analysis
Hirata, I., Hanaoka, S., Rokutanda, R., Funakoshi, R., & Hayashi, H. (2023) · Journal of Pharmacy & Pharmaceutical Sciences · doi:10.3389/jpps.2023.11135 · Cited by 6 · see citing works
“The number of drugs used was classified into two categories based on a previous report on polypharmacy (13).”
Background
The Role of a Clinical Pharmacist in the Identification of Potentially Inadequate Drugs Prescribed to the Geriatric Population in Low-Resource Settings Using the Beers Criteria: A Pilot Study
Kovačević, T., Davidović, M. S., Barišić, V., Fazlić, E., Miljković, S., Djajić, V., Miljković, B., & Kovačević, P. (2024) · Pharmacy · doi:10.3390/pharmacy12030084 · Cited by 6 · see citing works
“In HICs, people aged 65 to 74 years reported three times more adverse drug reactions, per million inhabitants per year, compared to younger people aged 5 to 19 years [4].”
BackgroundInfluential
Deprescribing
Diggins, K. C. (2019) · The Nurse Practitioner · doi:10.1097/01.npr.0000554677.33988.af · Cited by 6 · see citing works
What older adults and their caregivers need for making better health-related decisions at home: a participatory mixed methods protocol
Lai, C. K. Y., Holyoke, P., Plourde, K. V., Décary, S., & Légaré, F. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039102 · Cited by 6 · see citing works
Drug–drug interactions: A descriptive analysis of FDA adverse event reporting system
Alahmari, A. K., Fatani, S., & Ahmed, N. J. (2025) · Medicine · doi:10.1097/md.0000000000044606 · Cited by 5 · see citing works
District nurses’ experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care: a qualitative study
Lagerin, A., Törnkvist, L., Fastbom, J., & Lundh, L. (2021) · Primary Health Care Research & Development · doi:10.1017/s1463423621000530 · Cited by 5 · see citing works
“, 2018), which increases the risk of ADR and drug– drug interactions and has a negative impact on medication adherence (Hughes, 2004; Lagerin et al., 2014; Kim, 2017).”
Background
Prevalência das doenças crônicas não transmissíveis: hipertensão arterial, diabetes mellitus e fatores de risco associados em pessoas idosas longevas
da Silva, A. M., do Carmo, A. S., Alves, V. P., & de Carvalho, L. S. F. (2023) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2022-0592pt · Cited by 5 · see citing works
Elderly patients with comorbid hypertension who prefer primary care have a lower rate of polypharmacy: A cross-sectional study in Shanghai, China
Wu, W., Tang, Q., Wang, C., Cao, Y., Liu, Z., Li, X., Chen, G., & Lü, J. (2022) · BioScience Trends · doi:10.5582/bst.2022.01021 · Cited by 5 · see citing works
“Polypharmacy: at present, there is no recognized definition of polypharmacy in the international academic community, and there are still differences in the number and degree of multiple drug uses (16-17).”
Background
Herbal medicine for insomnia in elderly with hypertension: A systematic review and meta-analysis
Kwon, C., Lee, B., Chung, S.-Y., Kim, J. W., & Kim, S.-H. (2019) · European Journal of Integrative Medicine · doi:10.1016/j.eujim.2019.100961 · Cited by 5 · see citing works
Self-citation
Comparative Analysis of Drugs Frequently Suspected of Causing Adverse Drug Reactions Reported via the Spontaneous Reporting System Versus in a Prospective Multicentre Cohort Study in Hospital Emergency Departments
Graeff, V., Wehler, M., Dormann, H., Stingl, J., Just, K. S., & Eisert, A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14175921 · Cited by 4 · see citing works
“In addition to PIMs, the increase in the number of drug therapies with increasing age due to comorbidities has been scientifically proven [39–41], and polypharmacy is a significant risk factor for the occurrence of ADRs [42].”
Insomnia and Benzodiazepine Use as Risk Factors for Erectile Dysfunction: Clinical Evidence and In Silico Analysis of Physicochemical Properties
Navarrete-Anaya, Y. V., Delgado‐Enciso, I., Hernández‐Fuentes, G. A., Diaz‐Martinez, J., Delgado‐Enciso, O. G., Sánchez-Arizmendi, A., Figueroa-Gutiérrez, A., Aguilar-Cota, J., Venegas-Ramírez, J., Calvo-Soto, P., et al. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14196951 · Cited by 5 · see citing works
“Clinically, these findings support the importance of evaluating sleep quality and medication use in older men with ED [42,43].”
Factors related to polypharmacy in elderly people assisted by a Family Health Unit in Manhuaçu – MG
da Silva, G. H. D. M., Silva, M. S. A., Oliveira, G. P. L., Pampolim, G., & Sogame, L. C. M. (2024) · Clinics Biopsychosocial · doi:10.54727/cbps.v1i1.2 · Cited by 4 · see citing works
Dietary supplement use is common in older adult drivers: an analysis from the AAA LongROAD study
Moran, R. J., Baird, S., DiGuiseppi, C. G., Eby, D. W., Hacker, S., Isom, C. A., Jones, V., Lee, K. C., Li, G., Molnar, L. J., et al. (2024) · BMC Complementary Medicine and Therapies · doi:10.1186/s12906-024-04623-x · Cited by 4 · see citing works
Development and validation of the discharge severity index for post-emergency department hospital readmissions
Kijpaisalratana, N., Ariss, A.-B., Balk, A., Mitragotri, S., Samadian, K. D., Hahn, B. J., Coleska, A., Baugh, J. J., Hassan, A., Lee, J., et al. (2025) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2025.04.045 · Cited by 4 · see citing works

Nursing: polypharmacy and medication management in older adults
Kim, J., & Parish, A. L. (2021) · Clinics in Integrated Care · doi:10.1016/j.intcar.2021.100070 · Cited by 7 · see citing works
Self-citation
Medication reviews in elderly patients: Substantial variation in daily practice
Hurkens, K. P. G. M., Gonzalvo, C. M., de Wit, H. A. J. M., van der Kuy, P. H. M., Janknegt, R., Verhey, F. R. J., Schols, J. M. G. A., Stehouwer, C. D. A., & Mulder, W. J. (2013) · European Geriatric Medicine · doi:10.1016/j.eurger.2013.07.611
Nursing and Polypharmacy
Brathwaite, B. M. (2023) · Springer eBooks · doi:10.1007/978-3-031-30651-8_60
Polypharmacy
Bowles, S. K. (2016) · Springer eBooks · doi:10.1007/978-3-319-32304-6_4
NURSING
(2023) · Journal of The Indian Academy of Geriatrics · doi:10.4103/jiag.jiag_65_23

Authors: Kim, J., & Parish, A. L.
Affiliations: Vanderbilt University (US)
Corresponding author: Kim, Jennifer
ORCID: Parish, Abby Luck
Venue: Nursing Clinics of North America
Publisher: Elsevier BV
Published: 2017-09
Volume: 52
Issue: 3
Pages: 457-468
ISSN: 0029-6465 (ISSN-L)
DOI: 10.1016/j.cnur.2017.04.007
OpenAlex: W2739733993
Cited by: 245
References: 45
Citations by year: 2026: 15 · 2025: 28 · 2024: 47 · 2023: 44 · 2022: 34 · 2021: 38 · 2020: 15 · 2019: 18 · 2018: 6
FWCI: 1.22
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Nursing Clinics of North America (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords: polypharmacy, older adults, medication management, potentially inappropriate medications, adverse drug reactions, geriatric syndromes, patient-centered care, non-pharmacological treatment, quality of life, nursing care
MeSH terms: Aged, Humans, Polypharmacy, Nurse's Role, Medication Therapy Management, Drug-Related Side Effects and Adverse Reactions

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Polypharmacy and Medication Management in Older Adults

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