Pharmaceutical Counselling as a Strategy to Mitigate Polypharmacy in Older Adults: A Narrative Review
Keywords:
Pharmaceutical Counselling, Polypharmacy, Deprescribing, Older Adults, Medication Review, Geriatric PharmacotherapyAbstract
Polypharmacy in older adults is increasing worldwide, driving adverse drug events and avoidable healthcare costs. This review evaluates how pharmaceutical counselling can mitigate inappropriate polypharmacy and promote safe deprescribing. A structured search of PubMed, Scopus and Google Scholar (2013 2024) identified peer reviewed studies examining pharmacist led counselling or medication review in adults aged ≥ 60 years. Independent dual screening and thematic synthesis were applied. Results and Discussion: Forty two eligible studies showed polypharmacy prevalence up to 90 % in hospital cohorts and 60 % in community samples. Counselling interventions reduced mean medicine counts by 1 4 drugs and cut medication related problems by up to 45 %. Collaborative models that integrated pharmacists into multidisciplinary care achieved the greatest reductions in hospital readmissions and adverse events. Barriers included limited geriatric training, fragmented data systems and patient resistance. Success depended on supportive policy frameworks, reimbursement of counselling time and culturally sensitive patient engagement. Pharmaceutical counselling is an effective, scalable strategy to curb inappropriate polypharmacy. Integrating routine medication review into primary and transitional care, expanding pharmacists’ authority and aligning incentives are critical next steps. Rigorous, context aware research is needed to sustain impact across diverse settings.
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