Key result
Tailored prescribing, age-stratified risk assessment, and deprescribing improve medication safety and clinical outcomes in older adults.
Why the study?
Medication use quality and safety in older adults are a global health priority due to increasing polypharmacy and age-related physiological changes, requiring a synthesis of recent evidence published after major updates to the STOPP/START and Beers Criteria.
Do contemporary geriatric pharmacotherapy, medication optimization, and deprescribing interventions improve medication safety, adherence, and clinical outcomes in older adults aged ≥65 years?
Systematic Review
Do contemporary geriatric pharmacotherapy, medication optimization, and deprescribing interventions improve medication safety, adherence, and clinical outcomes in older adults aged ≥65 years?
This rapid review of 10 recent studies underscores the necessity of individualized risk-benefit assessment, age-stratified prescribing, regular laboratory monitoring, and multidisciplinary deprescribing to optimize cardiovascular and general pharmacotherapy safety in older adults.
Answers are grounded in this paper and cite their sources.
Supports individualized prescribing and deprescribing in adults ≥65 years; extends recent trial evidence to cardiovascular pharmacotherapy.
Medication use quality and safety in older adults are a global health priority due to the increasing prevalence of polypharmacy and age-related physiological changes.This update synthesized recent high-impact studies published between January 2023 and March 2025 that advanced geriatric pharmacotherapy.Ten rigorously designed studies focusing on deprescribing, medication optimization, quality use of medicine, safety, adherence, and cardiovascular and cerebrovascular outcomes were identified through a systematic search in PubMed and manual screening of leading journals.The search included randomized trials and cohort studies evaluating interventions such as ferric carboxymaltose (FCM) for anemia, finerenone for heart failure, rivaroxaban for peripheral artery disease (PAD), and anticoagulation safety in frail and cirrhotic populations.Findings highlight the importance of individualized prescribing, age-stratified risk assessment, and integration of deprescribing strategies.The review underscores emerging challenges such as anemia risk with aspirin and the tolerability of bedtime diuretics.Implications for clinical practice include the need for regular monitoring, patient-centered approaches, and multidisciplinary collaboration.This synthesis informs future research directions and supports safer, more effective medication use in older adults.
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Khadka et al. (2026) conducted a systematic review in Medication management, polypharmacy, and cardiovascular/cerebrovascular conditions in older adults. Geriatric pharmacotherapy optimization, deprescribing, and cardiovascular/cerebrovascular medication strategies (including finerenone, rivaroxaban, febuxostat, tenecteplase, DOACs, aspirin, bedtime diuretics) vs. Standard care, placebo, or active comparators across included studies was evaluated on Medication safety, adherence, optimization, and cardiovascular and cerebrovascular clinical outcomes. Individualized prescribing, age-stratified risk assessment, and structured deprescribing across 10 recent studies improve medication safety and clinical outcomes in adults aged ≥65 years.
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