{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:46:02Z","timestamp":1790703962740,"version":"4.1.0"},"reference-count":120,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The rapid growth of the global aging population, projected to reach 2.1 billion older adults by 2050, presents major challenges for pharmacotherapy and drug delivery. Age-related physiological changes affecting pharmacokinetics and pharmacodynamics, widespread polypharmacy, and functional impairments such as dysphagia, cognitive decline, and sensory or motor limitations reduce the effectiveness and safety of conventional \u201cone-size-fits-all\u201d medication approaches. This review aimed to evaluate the major barriers to effective drug delivery in older adults and to assess emerging patient-centered and technology-driven drug delivery systems designed to improve medication adherence, safety, and therapeutic outcomes in geriatric populations. Methods: A comprehensive narrative review of current literature was conducted focusing on geriatric pharmacotherapy, age-related barriers to medication administration, and advanced drug delivery technologies. The review analyzed evidence regarding modified oral formulations, transdermal systems, long-acting injectables, implantable devices, nanotechnology-based platforms, digital health integrations, pharmacogenomics, biomarker-guided therapy, and deprescribing strategies including STOPP\/START criteria and Beers Criteria. Studies addressing polypharmacy, medication adherence, and personalized medicine in older adults were also evaluated. Results: Evidence indicates that older adults experience significant medication-related challenges due to multimorbidity, polypharmacy, and functional decline. Dysphagia affects more than half of nursing home residents, while polypharmacy prevalence reaches up to 86.6% in some populations. Emerging drug delivery technologies demonstrated potential to improve adherence, dosing precision, and patient convenience. Personalized approaches incorporating pharmacogenomics, biomarker-guided treatment, and AI-assisted dosing showed promise for optimizing therapy. However, major limitations remain, including underrepresentation of older adults in clinical trials, limited high-quality evidence supporting many polypharmacy interventions, and insufficient implementation of advanced drug delivery systems in routine clinical practice. Conclusions: Current evidence supports a transition from standardized medication approaches toward flexible, individualized, and patient-centered drug delivery strategies for older adults. Advanced delivery technologies and personalized pharmacotherapy may improve medication safety, adherence, and quality of life in aging populations, although stronger clinical evidence and broader implementation are still needed. Future progress will require interdisciplinary care models, improved geriatric representation in clinical research, and regulatory reforms supporting the integration of innovative drug delivery systems into routine healthcare practice.<\/jats:p>","DOI":"10.3390\/jcm15114359","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T17:11:04Z","timestamp":1780593064000},"page":"4359","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Advanced Drug Delivery Strategies in Geriatric Patients with Polypharmacy: Integrating Pharmacokinetics, Personalized Medicine, and Emerging Technologies"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5557-5464","authenticated-orcid":false,"given":"Dorota","family":"Bartusik-Aebisher","sequence":"first","affiliation":[{"name":"Department of Biochemistry and General Chemistry, Faculty of Medicine, University of Rzesz\u00f3w, 35-310 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Bania","sequence":"additional","affiliation":[{"name":"English Division Science Club, Faculty of Medicine, University of Rzesz\u00f3w, 35-310 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7062-4412","authenticated-orcid":false,"given":"Blassan P.","family":"George","sequence":"additional","affiliation":[{"name":"Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, P.O. Box 17011, Johannesburg 2028, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6851-5869","authenticated-orcid":false,"given":"Klaudia","family":"Dynarowicz","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and General Chemistry, Faculty of Medicine, University of Rzesz\u00f3w, 35-310 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2661-6570","authenticated-orcid":false,"given":"David","family":"Aebisher","sequence":"additional","affiliation":[{"name":"Department of Photomedicine and Physical Chemistry, Faculty of Medicine, University of Rzesz\u00f3w, 35-310 Rzesz\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Freitas, H.R., and Malva, J.O. (2025). 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