Polypharmacy and deprescribing

Overview

A 2026 meta-analysis of 545 studies and more than 16 million older adults found a pooled global polypharmacy prevalence of 50.4%, rising over time, with each additional medicine monotonically increasing mortality (HR 1.05), emergency presentation (1.02) and hospital admission (1.04).^[12] The number of drugs is itself the strongest predictor of inappropriate prescribing and adverse drug events — which makes the medication list, not the diagnosis list, the first thing to examine in any older adult.^[4]

Polypharmacy is not automatically wrong: a patient with heart failure, diabetes, atrial fibrillation and COPD may genuinely need eight medicines. The target is problematic polypharmacy — medicines without current indication, beyond life-expectancy benefit, causing harm, or interacting. Deprescribing is "the process of tapering or stopping drugs, aimed at minimising polypharmacy and improving patient outcomes" — planned, monitored, and documented like any other treatment.^[4]

References15ShowHide

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