Zafer YOLBAŞ, Hıdır SARI
Türkiye Aile Hekimliği Dergisi - 2026;30(1):57-67
Advancements in medical technologies, expanded access to healthcare services, and improvements in living conditions have significantly increased the average life expectancy worldwide. This demographic shift, coupled with declining fertility rates, has led to a rapid rise in the proportion of elderly individuals within populations. The increase in the prevalence of chronic diseases is leading to the widespread use of multiple medications and making the importance of appropriate medication use more visible in primary health care. Polypharmacy is a natural consequence of the burden of age-related chronic diseases, but it can also introduce additional risks during treatment processes. Studies report that the prevalence of polypharmacy varies widely. Among older adults, polypharmacy is associated with numerous adverse clinical and economic outcomes, including drug interactions, inappropriate medication use, poor treatment adherence, adverse drug reactions, increased risk of falls, functional decline, and higher rates of hospitalization. Prescription review programs, the implementation of guidelines that support appropriate medication use (Beers, STOPP/START, TIME, etc.), and patient-centered education approaches play an important role in preventing polypharmacy. Family physicians working in primary health care play a central role in the early detection and appropriate management of polypharmacy, thanks to their ability to conduct long-term monitoring of elderly individuals and establish continuous physician-patient relationships. Additionally, AI-powered clinical decision support systems can enhance treatment safety by facilitating the detection of drug interactions and potentially inappropriate medication use. Strengthening collaboration between physicians and pharmacists in primary healthcare services, increasing awareness of medication management among older adults, and improving health literacy are among the key elements that support the effectiveness of the process. The aim of this review is to evaluate the frequency of polypharmacy in older adults, its economic and health outcomes, and prevention approaches based on current literature.
