Medicines optimisation and deprescribing in older people: personalised, proactive and preventative

Evidence shows that proactive multidisciplinary medication reviews reduce harm, prevent unnecessary hospital admissions, and improve quality of life for older people - while delivering value for money and supporting environmental sustainability. To realise these benefits at scale, medicines optimisation must be embedded as a core, routine element of primary care, supported by targeted investment, digital infrastructure, multidisciplinary training and public engagement. These actions will ensure that those most at risk benefit first, offering a practical and evidence based route to improving outcomes and supporting the long term sustainability of the NHS. This brief summarises the evidence on overprescribing and polypharmacy (10+ regular medicines) among older people in England, and the approaches shown to improve patient outcomes through safer prescribing practices.