Redefining polypharmacy: Shifting from drug counts to patient-centered clinical appropriateness

Abstract This narrative review examines the evolving perspectives on polypharmacy within geriatric pharmacotherapy, emphasizing transition from numerical definitions to clinical appropriateness. It addresses the complex relationship between polypharmacy and health outcomes in older adults. It integrates data from emerging technologies in medication management, prescribing criteria tools, and deprescribing interventions. Appropriate polypharmacy can be helpful for managing multimorbidity, whereas inappropriate polypharmacy raises the risk of adverse events and mortality. Deprescribing interventions effectively reduce polypharmacy and potentially inappropriate medications, particularly in long-term care settings. To address existing gaps, we have proposed a deprescribing scoring tool that allows healthcare professionals to evaluate each medication’s evidence base, risk profile, and alignment with patient goals. Prioritizing clinical relevance over medication count, along with innovative strategies such as deprescribing and new technologies, can improve therapeutic outcomes and quality of life for aging populations.