POLYPHARMACY AND MULTIMORBIDITY IN GERIATRICS: A NARRATIVE REVIEW
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Keywords
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Abstract
Polypharmacy is known to be the frequent use or administration of numerous drugs or an excessive number of drugs at the same time. Depending upon the medical profession, study population, and healthcare system, different definitions of polypharmacy exist. This includes any medication a patient takes, either prescribed, over-the-counter, or complementary and alternative medication rather than prescribed due to several factors that influence compliance in the treatment plan prescribed.
References
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23. Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC Fam Pract. 2017;18(1):70. Doi: 10.1186/s12875-017-0642-0.
24. American Geriatrics Society. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. Doi:10.1111/jgs.18372.
25. 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):625-632. Doi:10.1007/s41999-023-00777-y.
26. Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med. 2014;174(6):890-898. Doi:10.1001/jamainternmed.2014.949.
27. Lown Institute. Medication Overload: America’s Other Drug Problem. Brookline, MA: Lown Institute; 2019.
28. Morisky Medication Adherence Scale (MMAS-8) Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10(5):348-354. Doi:10.1111/j.1751-7176.2008.07572.x.
29 Li M, Tang H, Liu X. Primary care team and its association with quality of care for people with multimorbidity: a systematic review. BMC Primary Care. 2023;24:20
30. Sampalli R, Wong ST, Zwarenstein M, Ryan T. Scaling up patient-centered interdisciplinary care for multimorbidity: a pragmatic randomized controlled trial in family medicine groups. Ann Fam Med. 2021;19(2):126-134.
31 .Akyon SH, Akyon FC, Yılmaz TE. Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients. Front Med (Lausanne). 2023 Mar 8;10:1029198. Doi: 10.3389/fmed.2023.1029198.
32 .Cadogan CA, Ryan C, Hughes CM. Appropriate polypharmacy and medicine safety: when many is not too many. Drug Saf. 2016 Feb;39(2):109–16. Doi: 10.1007/s40264-015-0378-5.
2 . Pan Jia (Becky), Chen Xinxin (Zora). Factors affecting medication adherence in older person with polypharmacy: a literature review [Bachelor thesis]. Lishui (China): Lishui University, Faculty of Health and Occupational Studies, Department of Caring Sciences; 2024.
3. Barnsteiner JH. Medication reconciliation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter: Medication reconciliation.
4. Holbrook A, Schulman S, Witt DM, et al. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis (9th ed.). Chest. 2012;141(2 Suppl):e152S– e184S (warfarin/INR monitoring guidance).
5. National Institutes of Health, Office of Dietary Supplements. Dietary Supplement Fact Sheets for Health Professionals (vitamins, herbs, interactions, regulation). sBethesda (MD): NIH ODS; [updated regularly].
6. Skou ST, Mair FS, Fortin M, Guthrie B, Nunes BP, Miranda JJ, Boyd CM, Pati S, Mtenga S, Smith SM. Multimorbidity. Nat Rev Dis Primers. 2022 Jul 14;8(1):48. Doi:10.1038/s41572-022- 00376-4
7. Lu J, Wang Y, Hou L, Zuo Z, Zhang N, Wei A. Multimorbidity patterns in old adults and their associated multi-layered factors: a cross-sectional study. BMC Geriatr. 2021;21:372. Doi:10.1186/s12877-021-02292-w.
8. Boyd CM, McNabney MK, Brandt N, Correa-de-Araujo R, Daniel M, Epplin J, Fried TR, Goldstein MK, Holmes HM, Ritchie CS, Shega JW, American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. J Am Geriatr Soc. 2012 Oct;60(10):E1-E25.
Doi:10.1111/j.1532-5415.2012.04188.x. PMID: 22994865; PMCID: PMC4450364.
9) Melo LA, Braga LC, Leite FPP, Bittar BF, Oséas JM, Lima KC. Factors associated with multimorbidity in the elderly: an integrative literature review. Rev Bras Geriatr Gerontol. 2019;22(1). Doi:10.1590/1981-22562019022.180154.
10. Nicholson K, Liu W, Fitzpatrick D, Hardacre KA, Roberts S, Salerno J, et al. Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review. Lancet Healthy Longev. 2024;5(4):e287–e296. Doi:10.1016/S2666-7568(24)00007-2.
11. Nguyen H, Manolova G, Daskalopoulou C, Vitoratou S, Prince M, Prina AM. Prevalence of multimorbidity in community settings: a systematic review and meta-analysis of observational studies. J Comorbidity. 2019;9:2235042X19870934. Doi:10.1177/2235042X19870934.
12 .Aoki T, Yamamoto Y, Ikenoue T, Onishi Y, Fukuhara S; for the Scientific Reports Multimorbidity Study Group. Multimorbidity patterns in relation to polypharmacy and dosage frequency: a nationwide, cross-sectional study in a Japanese population. Sci Rep. 2018;8:3806. Doi:10.1038/s41598-018-21917-6.
13 .Aggarwal P, Woolford SJ, Patel HP. Multi-morbidity and polypharmacy in older people: challenges and opportunities for clinical practice. Geriatrics. 2020;5(4):85. Doi:10.3390/geriatrics5040085
14 .Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC Fam Pract. 2017;18(1):70. Doi: 10.1186/s12875-017-0642-0.
15. Garrard JW, Cox NJ, Dodds RM, Roberts HC, Sayer AA. Comprehensive geriatric assessment in primary care: a systematic review. Aging Clin Exp Res. 2020;32(2):197–205. doi:10.1007/s40520- 019-01183-w
16 .Stefanacci RG. Comprehensive geriatric assessment. In: Wasserman MR, reviewer. MSD Manual Professional Version [Internet]. Merck & Co., Inc.; reviewed and revised April 2024
17. Beck J, Sequeira E. PubMed Central (PMC): an archive for literature from life sciences journals. In: McEntyre J, editor. The NCBI handbook [Internet]. Bethesda (MD): National Library of Medicine (US), National Center for Biotechnology Information; 2002 Oct.
18. Devons CAJ. Comprehensive geriatric assessment: making the most of the aging years. Curr Opin Clin Nutr Metab Care. 2002 Jan;5(1):19–24. Doi: 10.1097/00075197-200201000-00004.
19. SG, McCue P, Phelps K, McCleod A, Arora S, Nockels K, et al. What is comprehensive geriatric assessment (CGA)? An umbrella review. Age Ageing. 2018;47(1):149-55. Doi:10.1093/ageing/afx166.
20. Saxena A, Singh S, Sharma S, et al. Multimorbidity management: A scoping review of interventions and models. J Multimorbidity Health. 2025
21. Forslund T, Carlsson AC, Ljunggren G, Ärnlöv J, Wachtler C. Patterns of multimorbidity and pharmacotherapy: a total population cross-sectional study. Fam Pract. 2021;38(1):132-9. Doi:10.1093/fampra/cmaa101.
22. Pearson-Stuttard J, Ezzati M, Gregg EW. Multimorbidity—a defining challenge for health systems. Lancet Public Health. 2019;4(12):e599-e600. Doi:10.1016/S2468-2667(19)30250-0.
23. Molokhia M, Majeed A. Current and future perspectives on the management of polypharmacy. BMC Fam Pract. 2017;18(1):70. Doi: 10.1186/s12875-017-0642-0.
24. American Geriatrics Society. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. Doi:10.1111/jgs.18372.
25. 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):625-632. Doi:10.1007/s41999-023-00777-y.
26. Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: the EMPOWER cluster randomized trial. JAMA Intern Med. 2014;174(6):890-898. Doi:10.1001/jamainternmed.2014.949.
27. Lown Institute. Medication Overload: America’s Other Drug Problem. Brookline, MA: Lown Institute; 2019.
28. Morisky Medication Adherence Scale (MMAS-8) Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008;10(5):348-354. Doi:10.1111/j.1751-7176.2008.07572.x.
29 Li M, Tang H, Liu X. Primary care team and its association with quality of care for people with multimorbidity: a systematic review. BMC Primary Care. 2023;24:20
30. Sampalli R, Wong ST, Zwarenstein M, Ryan T. Scaling up patient-centered interdisciplinary care for multimorbidity: a pragmatic randomized controlled trial in family medicine groups. Ann Fam Med. 2021;19(2):126-134.
31 .Akyon SH, Akyon FC, Yılmaz TE. Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients. Front Med (Lausanne). 2023 Mar 8;10:1029198. Doi: 10.3389/fmed.2023.1029198.
32 .Cadogan CA, Ryan C, Hughes CM. Appropriate polypharmacy and medicine safety: when many is not too many. Drug Saf. 2016 Feb;39(2):109–16. Doi: 10.1007/s40264-015-0378-5.
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Nov 08, 2025
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Dr. Priyanka N, Ms.Boomika S, Ms.Harini S, Ms.Goverthini R, & Ms.Vijayalakshmi C. (2025). POLYPHARMACY AND MULTIMORBIDITY IN GERIATRICS: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 32(10), 230-246. https://doi.org/10.53555/8rexvz71
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Author Biographies
Dr. Priyanka N
Assistant Professor, Department of Pharmacology, GRT Institute of Pharmaceutical Education and Research, Tiruttani, India
Ms.Boomika S
GRT Institute of Pharmaceutical Education and Research Tiruttani, India
Ms.Harini S
GRT Institute of Pharmaceutical Education and Research Tiruttani, India
Ms.Goverthini R
GRT Institute of Pharmaceutical Education and Research Tiruttani, India
Ms.Vijayalakshmi C
GRT Institute of Pharmaceutical Education and Research Tiruttani, India
How to Cite
Dr. Priyanka N, Ms.Boomika S, Ms.Harini S, Ms.Goverthini R, & Ms.Vijayalakshmi C. (2025). POLYPHARMACY AND MULTIMORBIDITY IN GERIATRICS: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 32(10), 230-246. https://doi.org/10.53555/8rexvz71