Structured medication review for polypharmacy – systematic review

Jeindl R, Kern-Kim J
Record ID 32018015450
English
Authors' objectives: Polypharmacy (≥5 long-term medicines) is common among older, multimorbid adults and increases medication-related risks. Structured medication reviews (SMRs) aim to improve medication safety. This report synthesised evidence on effectiveness, safety, organisation and costs, and compared European implementation to inform decision-making in Austria.
Authors' results and conclusions: Two umbrella reviews and three systematic reviews were included, showing low risk of bias but predominantly low-quality primary evidence. SMRs reduced potentially inappropriate medication and missing indicated therapies, with small effects on adherence. No clear mortality reduction was found; results for hospitalisations and quality of life were mixed, with no relevant safety concerns.
Authors' recommendations: SMRs should primarily be considered a measure to enhance medication safety. Implementation should prioritise high-risk patients, standardised components, clear communication pathways, use of digital medication data, and accompanying health services research.
Authors' methods: Systematic searches for umbrella reviews, systematic reviews and guidelines published since 2020. Outcomes included medication-related, clinical, organisational and economic endpoints; quality was assessed using ROBIS and AGREE II. A qualitative analysis compared implementation models in six European countries.
Details
Project Status: Completed
URL for project: https://aihta.at/page/strukturierte-medikationsanalyse-bei-polypharmazie/en
Year Published: 2026
URL for published report: https://eprints.aihta.at/1600/1/HTA-Projektbericht_Nr.175.pdf
URL for additional information: https://eprints.aihta.at/1600
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Polypharmacy
  • Medication Review
  • Drug-Related Side Effects and Adverse Reactions
  • Overtreatment
  • Deprescriptions
Keywords
  • Structured medication review
  • polypharmacy
  • medication safety
  • deprescribing
  • implementation
Contact
Organisation Name: Austrian Institute for Health Technology Assessment
Contact Address: Josefstaedter Strasse 39, A-1080 Vienna, Austria
Contact Name: office@aihta.at
Contact Email: office@aihta.at
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.