MULTIMORBIDITY AND POLYPHARMACY IN OLDER ADULTS: CHALLENGES FOR HEALTHCARE SYSTEMS AND STRATEGIES FOR MEDICATION OPTIMIZATION — A NARRATIVE REVIEW

Urszula Przewoźna; Gabriela Stępień; Izabela Szubert; Jakub Lamorski; Julia Suchecka; Karolina Chudecka; Katarzyna Józwa; Michał Chylewski; Aleksandra Kędzierska; Wiktor Nesterak; Jędrzej Łysiak; Amin Abdulgater; Leonard Bühner

doi:10.31435/ijitss.2(50).2026.5845

Authors

Urszula Przewoźna University Clinical Hospital No. 2 PMU, Szczecin, Poland https://orcid.org/0009-0003-2186-6604
Gabriela Stępień University Clinical Hospital No. 2 PMU, Szczecin, Poland https://orcid.org/0009-0006-4505-5162
Izabela Szubert Independent Public Provincial Integrated Hospital in Szczecin, Szczecin, Poland https://orcid.org/0009-0006-7162-6651
Jakub Lamorski Independent Public Provincial Integrated Hospital in Szczecin, Szczecin, Poland https://orcid.org/0009-0004-5456-7413
Julia Suchecka Independent Public Provincial Integrated Hospital in Szczecin, Szczecin, Poland https://orcid.org/0009-0001-9975-355X
Karolina Chudecka Independent Public Provincial Integrated Hospital in Szczecin, Szczecin, Poland https://orcid.org/0009-0004-0262-5036
Katarzyna Józwa Independent Public Provincial Integrated Hospital in Szczecin, Szczecin, Poland https://orcid.org/0009-0003-5615-2388
Michał Chylewski Pomeranian Medical University, Szczecin, Poland https://orcid.org/0009-0007-4789-1903
Aleksandra Kędzierska Independent Public Provincial Integrated Hospital in Szczecin, Szczecin, Poland https://orcid.org/0009-0008-7050-4139
Wiktor Nesterak Pomeranian Medical University, Szczecin, Poland https://orcid.org/0009-0009-5322-903X
Jędrzej Łysiak University Clinical Hospital No. 2 PMU, Szczecin, Poland https://orcid.org/0009-0005-5798-3620
Amin Abdulgater University Clinical Hospital No. 2 PMU, Szczecin, Poland https://orcid.org/0009-0000-3782-5776
Leonard Bühner Asklepios Klinik, Germany https://orcid.org/0009-0001-0143-0673

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5845

Keywords:

Polypharmacy, Multimorbidity, Older Adults, Public Health, Healthcare Systems, Deprescribing

Abstract

Background: Population aging has contributed to a substantial increase in multimorbidity and polypharmacy among older adults worldwide. The coexistence of multiple chronic diseases frequently requires complex pharmacotherapy, increasing the risk of medication-related harm and adverse clinical outcomes. Beyond clinical consequences, polypharmacy represents an important public health and healthcare system challenge associated with increased hospitalization rates, healthcare expenditure, and growing demand for interdisciplinary care.

Aim: The aim of this narrative review was to summarize current evidence regarding multimorbidity and polypharmacy in older adults and to discuss contemporary strategies for medication optimization and deprescribing from both clinical and public health perspectives. Methods: A structured literature review was conducted using the PubMed, Scopus, and Google Scholar database. Contemporary peer-reviewed studies published between 2015 and 2026 focusing on epidemiology, adverse outcomes, inappropriate prescribing, medication review, deprescribing interventions, and healthcare system implications in older adults were included.

Results: Current evidence demonstrates that polypharmacy is strongly associated with adverse drug reactions, falls, frailty, hospitalization, cognitive decline, and increased mortality risk. Recent studies additionally indicate that medication review, multidisciplinary interventions, pharmacist-led care, and deprescribing strategies may improve medication appropriateness, reduce inappropriate prescribing, and decrease treatment burden among older adults.

Conclusions: Effective management of polypharmacy requires patient-centered care, interdisciplinary collaboration, and healthcare system-level interventions aimed at improving medication safety and optimizing clinical outcomes in aging populations.

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