{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:02:53Z","timestamp":1791558173152,"version":"4.3.4"},"reference-count":32,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Polypharmacy is a serious health issue for older adults worldwide, including in Japan, which has a rapidly aging society. The \u201cProper Medication Guideline for Older Adults\u201d was published for healthcare providers in May 2018, and polypharmacy reduction incentives were initiated for medical facilities in April 2016 and April 2018. This study identified the long-term reduction in polypharmacy prescriptions focusing on older adults aged 75 years and above from April 2015 to March 2019. The national health insurance claims database, which covers most reimbursement claims in Japan, was selected as the primary data source. In this study, polypharmacy was defined as the simultaneous prescription of seven or more medications or multi-psychotropic medications. The primary outcome was the polypharmacy reduction ratio, which indicates the decrease in polypharmacy proportion based on the number of medications on an outpatient prescription. A total polypharmacy reduction of 19.3% for the \u201c75\u201389 years\u201d subgroup and 16.5% for the \u201c90 years and above\u201d subgroup was observed over four years. Based on prefecture analysis, the mean values of polypharmacy proportion showed a statistically significant reduction over four years. This study showed a successful nationwide reduction in polypharmacy prescriptions after implementing the polypharmacy management guidelines for older adults and incentive-based policies.<\/jats:p>","DOI":"10.3390\/ijerph192214684","type":"journal-article","created":{"date-parts":[[2022,11,10]],"date-time":"2022-11-10T01:48:08Z","timestamp":1668044888000},"page":"14684","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Nationwide Long-Term Evaluation of Polypharmacy Reduction Policies Focusing on Older Adults in Japan"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4955-3055","authenticated-orcid":false,"given":"Takehiro","family":"Ishida","sequence":"first","affiliation":[{"name":"Graduate School of Public Health, Teikyo University, Itabashi-ku, Tokyo 173-8605, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5102-696X","authenticated-orcid":false,"given":"Asuka","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, Teikyo University, Itabashi-ku, Tokyo 173-8605, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2252-3358","authenticated-orcid":false,"given":"Yoshinori","family":"Nakata","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, Teikyo University, Itabashi-ku, Tokyo 173-8605, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.japh.2017.06.002","article-title":"Association between polypharmacy and death: A systematic review and meta-analysis","volume":"57","author":"Leelakanok","year":"2017","journal-title":"J. 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