Guidance to manage inappropriate polypharmacy in older people: systematic review and future developments

SIMPATHY Consortium

Research output: Contribution to journalReview articlepeer-review


Single disease state led evidence-based guidelines do not provide sufficient coverage of issues of multimorbidities, with the cumulative impact of recommendations often resulting in overwhelming medicines burden. Inappropriate polypharmacy increases the likelihood of adverse drug events, drug interactions and non-adherence. Areas covered: A detailed description of a pan-European initiative, 'Stimulating Innovation Management of Polypharmacy and Adherence in the Elderly, SIMPATHY', which is a project funded by the European Commission to support innovation across the European Union. This includes a systematic review of the literature aiming to summarize and review critically current policies and guidelines on polypharmacy management in older people. The policy driven, evidence-based approach to managing inappropriate polypharmacy in Scotland is described, with consideration of a change management strategy based on Kotter's eight step process for leading sustainable change. Expert opinion: The challenges around promoting appropriate polypharmacy are on many levels, primarily clinical, organisational and political, all of which any workable solution will need to address. To be effective, safe and efficient, any programme that attempts to deal with the complexities of prescribing in this population must be patient-centred, clinically robust, multidisciplinary and designed to fit into the healthcare system in which it is delivered.

Original languageEnglish
Pages (from-to)203-213
Number of pages11
JournalExpert Opinion on Drug Safety
Issue number2
Publication statusPublished - Feb 2017


  • Aged
  • Drug Interactions
  • Drug-Related Side Effects and Adverse Reactions/epidemiology
  • European Union
  • Evidence-Based Medicine
  • Health Policy
  • Humans
  • Inappropriate Prescribing/prevention & control
  • Medication Adherence
  • Polypharmacy
  • Practice Guidelines as Topic


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