{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T17:26:45Z","timestamp":1793467605734,"version":"4.5.0"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Background\/Objective: Polypharmacy, conventionally defined as the concurrent use of five or more medications, has emerged as a critical public health challenge in aging populations worldwide. Polypharmacy in older adults, driven by multimorbidity and age-related physiological changes, increases the risk of adverse drug reactions, drug interactions, falls, cognitive impairment, non-adherence, and preventable hospitalization. This study aims to provide a structured narrative synthesis of the current evidence on the incidence, risk factors, and clinical management of polypharmacy in elderly patients, with particular emphasis on deprescribing strategies, interdisciplinary care models, patient education, and digital clinical decision support technologies. Methods: A structured narrative literature review was conducted across PubMed, Scopus, and Web of Science using Boolean combinations of MeSH and free text terms including \u2018polypharmacy,\u2019 \u2018elderly,\u2019 \u2018deprescribing,\u2019 and \u2018medication review.\u2019 Eligible sources were peer-reviewed primary studies published between January 2016 and June 2026 that enrolled adults aged \u226565 years and reported validated prescribing review approaches, such as the STOPP\/START criteria. The review drew on 40 primary studies spanning randomized controlled trials (RCTs) and observational, qualitative, and mixed-methods designs, which were interpreted and synthesized narratively across the principal thematic domains of polypharmacy management. Results: Polypharmacy was independently and consistently associated with DDIs, preventable hospitalizations, and functional decline across diverse clinical settings. Pharmacist-led medication reviews and interdisciplinary, team-based interventions produced the most robust improvements in prescribing appropriateness and meaningful reductions in potentially inappropriate medications (PIMs). Electronic clinical decision support systems (CDSSs) have demonstrated measurable benefits for safe deprescribing at scale, although usability limitations, incomplete workflow integration, and clinician resistance are significant implementation obstacles. Conclusions: Effective management of polypharmacy in older adults requires a multicomponent, patient-centered strategy that integrates evidence-based deprescribing algorithms, principally the STOPP\/START criteria, sustained interdisciplinary collaboration, structured patient education, and technology-assisted decision support.<\/jats:p>","DOI":"10.3390\/geriatrics11040096","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:55:11Z","timestamp":1785419711000},"page":"96","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Polypharmacy in Older Adults: A Narrative Review of Clinical Risks, Deprescribing Strategies, and Interdisciplinary Management"],"prefix":"10.3390","volume":"11","author":[{"given":"Himat Hussein","family":"Mamand","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, University of P\u00e9cs, V\u00f6r\u00f6smarty Mih\u00e1ly Str. 4, 7621 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5621-4935","authenticated-orcid":false,"given":"N\u00f3ra","family":"Rozmann","sequence":"additional","affiliation":[{"name":"Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of P\u00e9cs, V\u00f6r\u00f6smarty Mih\u00e1ly Str. 4, 7621 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9011-1112","authenticated-orcid":false,"given":"Mikl\u00f3s","family":"Sug\u00e1r","sequence":"additional","affiliation":[{"name":"Institute of Emergency Care, Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of P\u00e9cs, V\u00f6r\u00f6smarty Mih\u00e1ly Str. 4, 7621 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7694-7503","authenticated-orcid":false,"given":"Ahmed Lateef Abed","family":"Alkhaqani","sequence":"additional","affiliation":[{"name":"Doctoral School of Health Sciences, Faculty of Health Sciences, University of P\u00e9cs, V\u00f6r\u00f6smarty Mih\u00e1ly Str. 4, 7621 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saya","family":"Hama","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Raparin, Main Street, Ranya 46012, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9551-8440","authenticated-orcid":false,"given":"Bence","family":"Raposa","sequence":"additional","affiliation":[{"name":"Institute of Basics of Health Sciences, Midwifery and Health Visiting, Faculty of Health Sciences, University of P\u00e9cs, V\u00f6r\u00f6smarty Mih\u00e1ly Str. 4, 7621 P\u00e9cs, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/cts.13438","article-title":"Factors related to polypharmacy and hyper-polypharmacy for the elderly: A nationwide cohort study using National Health Insurance data in South Korea","volume":"16","author":"Cho","year":"2023","journal-title":"Clin. 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