The effect of a medication review on the quality of life of community dwelling frail adults with polypharmacy: a scoping review

Old people living with frailty are more susceptible to side effects from polypharmacy, which can lead to poor quality of life (QOL). Medication review is considered an important intervention; it includes a structured assessment of individuals’ medications in view of drug-drug interactions, medication appropriateness and side effects. Thus, it constitutes an important concept for reducing the side effects of polypharmacy. The aim of this scoping review was to map the evidence and identify research gaps. A systematic scoping review of the literature was conducted following Arksey and O’Malley’s framework [1]. Studies were eligible if the included participants were above 65 years of age, living with frailty and polypharmacy (more than five prescribed medications). Thematic and content analysis were used to analyse the charted data. The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. The results of the nine included studies indicated little or no significant effect of the medication review intervention on the QOL, although some studies showed a tendency towards positive outcomes, Furthermore, QOL was not conceptualised, and the authors did not explore any correlation between the different levels of frailty/polypharmacy and the selected outcomes within each included study. This scoping review highlights significant methodological heterogeneity in studies on medication review and its impact on QOL in frail patients with polypharmacy. While short-term trends suggest potential benefits, the lack of standardized methods, small sample sizes, and short intervention durations limit generalisability and clinical applicability. The review calls for more long-term, standardized research using frailty-specific QOL tools.