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

Stewart, Derek; Mair, Alpana; Wilson, Martin; Kardas, Przemyslaw; Lewek, Pawel; Alonso, Albert; McIntosh, Jennifer; MacLure, Katie


Derek Stewart

Alpana Mair

Martin Wilson

Przemyslaw Kardas

Pawel Lewek

Albert Alonso

Jennifer McIntosh

Katie MacLure


SIMPATHY Consortium
Data Collector


Introduction: 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.


STEWART, D., MAIR, A., WILSON, M., KARDAS, P., LEWEK, P., ALONSO, A., MCINTOSH, J., MACLURE, K. and SIMPATHY Consortium. 2017. Guidance to manage inappropriate polypharmacy in older people: systematic review and future developments. Expert opinion on drug safety [online], 16(2), pages 203-213. Available from:

Journal Article Type Review
Acceptance Date Nov 23, 2016
Online Publication Date Dec 4, 2016
Publication Date Feb 1, 2017
Deposit Date Jan 9, 2017
Publicly Available Date Dec 5, 2017
Journal Expert opinion on drug safety
Print ISSN 1474-0338
Electronic ISSN 1744-764X
Publisher Taylor and Francis
Peer Reviewed Peer Reviewed
Volume 16
Issue 2
Pages 203-213
Keywords Aged; Inappropriate prescribing; Literature review; Organisational change; Polypharmacy; SIMPATHY
Public URL


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