{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:55:49Z","timestamp":1782129349205,"version":"3.54.5"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["1R01\u2010AG088214\u201001"],"award-info":[{"award-number":["1R01\u2010AG088214\u201001"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["K23AG076889"],"award-info":[{"award-number":["K23AG076889"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG057806"],"award-info":[{"award-number":["R33AG057806"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n \n Central nervous system (\n CNS<\/jats:styled-content>\n )\u2010active polypharmacy is associated with increased risks such as impaired cognition and falls. In 2021,\n CNS<\/jats:styled-content>\n \u2010active polypharmacy was added as a Medicare Part D display measure to monitor for this risk. Enrollees in the Medicare Part D Medication Therapy Management program are at increased risk of\n CNS<\/jats:styled-content>\n \u2010active polypharmacy and are offered comprehensive medication reviews (\n CMRs<\/jats:styled-content>\n ) to optimize their medication management and reduce medication\u2010related safety risks.\n <\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n \n Evaluate the association of\n CMRs<\/jats:styled-content>\n with\n CNS<\/jats:styled-content>\n \u2010active medication discontinuation among Medication Therapy Management enrollees in 2021.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Observational study applying inverse probability of treatment weights to compare the time until discontinuation of at least one medication contributing to\n CNS<\/jats:styled-content>\n \u2010active polypharmacy in\n CMR<\/jats:styled-content>\n recipients versus non\u2010recipients in 2021 using 5% Medicare fee\u2010for\u2010service claims and enrollment data.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 2702 community\u2010dwelling, Medication Therapy Management program enrollees \u2265\u200966\u2009years of age with\n CNS<\/jats:styled-content>\n \u2010active polypharmacy, 969 (35.9%) were\n CMR<\/jats:styled-content>\n recipients. Both\n CMR<\/jats:styled-content>\n recipients and non\u2010recipients were taking a median of four\n CNS<\/jats:styled-content>\n \u2010active medications. As compared to non\u2010recipients pre\u2010weighting,\n CMR<\/jats:styled-content>\n recipients were more likely to use certain\n CNS<\/jats:styled-content>\n \u2010active medications, such as antidepressants, antiseizure medications, benzodiazepines, and nonbenzodiazepine sedative hypnotics and opioids. Compared to non\u2010recipients pre\u2010weighting,\n CMR<\/jats:styled-content>\n recipients were also more likely to have more prescribers contributing to the\n CNS<\/jats:styled-content>\n \u2010active polypharmacy and to have a mix of prescriber types involved. Comparable numbers of CMR and non\u2010CMR patients discontinued at least one CNS\u2010active medication within 1 year (11.5% vs. 13.2%). In the weighted analyses, there was no difference in likelihood of discontinuation of at least one CNS\u2010active medication between CMR recipients and non\u2010recipients (hazard ratio\u2009=\u20091.03, 95% confidence interval\u2009=\u20090.94\u20131.12).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CMRs<\/jats:styled-content>\n were not associated with reduced\n CNS<\/jats:styled-content>\n \u2010active polypharmacy in older adults in the first year that it served as a Part D Display measure. Future research is needed to better understand why and whether this continues.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.70275","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T12:12:15Z","timestamp":1766837535000},"page":"685-694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comprehensive Medication Reviews in Medicare Were Not Associated With Reduced Central Nervous System\u2010Active Polypharmacy in 2021"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0730-431X","authenticated-orcid":false,"given":"Anna","family":"Hung","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham North Carolina USA"},{"name":"Duke\u2010Margolis Institute for Health Policy Durham North Carolina USA"},{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan N.","family":"Hastings","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham North Carolina USA"},{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation Durham VA Health Care System North Carolina USA"},{"name":"Center for the Study of Aging and Human Development Duke University Durham North Carolina USA"},{"name":"Geriatrics Research, Education, and Clinical Center Durham Veterans Affairs Health Care System North Carolina USA"},{"name":"Department of Biostatistics and Bioinformatics Duke University School of Medicine Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline E.","family":"Sloan","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Duke University School of Medicine Durham North Carolina 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