Nursing Strategies for Polypharmacy Management in Older Adults: Effectiveness, Challenges, and Future Directions – A Systematic Review

Polypharmacy, the concurrent use of multiple medications, is a growing threat to older adults’ health, elevating risks for adverse drug events, hospital admissions, and functional decline. Effective medication management, led by nurses, is essential to reduce these risks and optimize therapeutic outcomes. A systematic review was performed in line with PRISMA guidelines. Searches of Medline, CINAHL, and Cochrane Library were conducted for systematic reviews and meta-analyses published in English from January ۲۰۲۰ to April ۲۰۲۵, focusing on nurse-led polypharmacy management in adults aged ۶۵ and over. Fourteen systematic reviews involving over ۲۴,۰۰۰ older participants were included. Nurse-driven interventions—such as comprehensive medication review, patient education, collaboration with pharmacists and prescribers, computerized alerts, and deprescribing protocols—consistently reduced inappropriate medication use, medication errors, and risk of hospitalization. Integration of electronic medication administration records (eMARs) and digital reminders improved adherence and reduced missed doses. Barriers included limited access to updated training in geriatric pharmacology, time constraints, and lack of standardized assessment tools. Interdisciplinary teamwork greatly enhanced intervention success, particularly in long-term care and community settings. Nurse-led polypharmacy management is effective in reducing medication-related harm in older adults. Robust protocols, ongoing education, and interdisciplinary collaboration are key. Further research should investigate the long-term efficacy, cost-effectiveness, and digital health applications in this domain.

کلیدواژه ها:

Polypharmacy ، Older Adults ، Nursing Strategies ، Medication Management ، Systematic Review