This study investigated Finnish veterinarians' perceptions of medication safety risks in sows, an area with limited research in veterinary medicine. Understanding these risks is essential for enhancing sow medication safety, health and welfare. This qualitative study was conducted using semi-structured, thematic individual interviews with 15 veterinarians who provide herd health visit services to sow farms. The interviews employed open-ended questions to elicit in-depth information from participants. Thematic analysis of the transcribed interviews was conducted using the ATLAS.ti software to identify key medication safety risks. The analysis identified eight key risk themes: (1) overreliance on caretakers' competence; (2) insufficient veterinary guidance; (3) communication and information barriers; (4) challenges with medicine logistics and availability; (5) unhygienic and inappropriate medication practices; (6) insufficient sick sow examination and follow-up; (7) injection-related pain and insufficient pain management; and (8) challenges in farm conditions and management. Recognizing medication safety risks is vital for veterinarians to effectively guide and monitor medicine use, ensuring optimal care for sows. This study offers new perspectives into these risks within veterinary medicine, particularly concerning animals used for food production. By identifying key risks that can jeopardize medication safety, this study provides valuable information for producers, veterinarians, policymakers, and regulatory bodies. Understanding these mechanisms enables stakeholders to develop targeted systems-based protocols that enhance sow health and welfare while promoting safer and more responsible medication practices.

To quantify polypharmacy (≥5 drugs) and hyperpolypharmacy (≥10 drugs) in pacemaker recipients aged ≥65 years and to assess associations with frailty (FRAIL), physical activity (IPAQ), medication adherence (MAT), and healthcare utilization over 6 months. Polypharmacy is common in elderly patients with cardiac devices, but prospective data from European pacemaker clinics on frailty, physical activity, adherence, and prescribing quality are limited. Prospective, single-center observational study in a Portuguese tertiary pacemaker outpatient clinic (n=104). Participants (≥65 years) were assessed at enrolment and at 3 and 6months. FRAIL, IPAQ, and MAT were recorded at each timepoint. Healthcare utilization was defined as emergency department visits and/or hospital admissions. STOPP/START v3 was applied descriptively at 6months. Mean age was 79.1±7.5 years; 69.2% were men. Polypharmacy and hyperpolypharmacy were present in 49.0% and 38.5% at enrolment and 47.5% and 43.4% at 6 months. A higher number of chronic medications was associated with higher FRAIL scores, lower IPAQ scores and more frequent healthcare utilization, whereas MAT scores remained uniformly high. Cardiovascular drugs, diuretics, and proton-pump inhibitors (PPIs) were the most frequently used classes. STOPP/START identified potentially inappropriate medications (notably PPIs and benzodiazepines) and prescribing omissions according to START (notably cardiovascular therapies). Polypharmacy and hyperpolypharmacy are frequent and persistent in elderly pacemaker recipients and are associated with frailty, lower physical activity and higher healthcare utilization. Structured medication review during routine follow-up may help identify PIMs and PPOs and optimize pharmacotherapy.

To identify potentially inappropriate medications (PIMs) using deprescribing tools and to evaluate longitudinal changes in the number of PIMs and their associated costs between baseline (T₀) and follow-up (TF) among patients receiving outpatient palliative care (PC). This retrospective longitudinal study reviewed electronic medical records of adult patients (≥18 years) who initiated follow-up in 2022 at an outpatient PC clinic of a Brazilian teaching hospital. Patients were monitored for up to 12 months. PIMs were identified using the STOPPFrail version 2 (v2) and OncPal criteria at baseline (T₀) and at the last outpatient consultation (TF). Differences in the number of PIMs and their associated costs between T₀ and TF were analysed using descriptive statistics and paired comparisons with the Wilcoxon signed-rank test. Among 42 patients included in the longitudinal analysis, STOPPFrail v2 identified a small but statistically significant increase in PIM exposure over time (median 3 (IQR 3-4) at T₀ vs 4 (IQR 3-5) at TF; p=0.041). Median PIM-related costs also increased, from US$0.06 (IQR 0.03-0.25) at T₀ to US$0.14 (IQR 0.04-0.26) at TF; however, this difference was not statistically significant (p=0.165). In contrast, according to the OncPal criteria, PIM exposure remained stable (median 4 (IQR 3-5) at both T₀ and TF; p=0.591). Likewise, PIM-related costs showed no significant change, increasing from US$0.05 (IQR 0.01-0.10) at T₀ to US$0.08 (IQR 0.04-0.14) at TF (p=0.117). PIM exposure remained high over time in outpatient PC, with minimal variation depending on the assessment tool used and no significant reduction in medication-related costs. These findings highlight the complexity of prescribing in this population and the need for new deprescribing strategies.

Geriatric syndromes including polypharmacy and multimorbidity represent growing public health challenges in aging rural populations, yet their population-level burden remains poorly quantified in low- and middle-income countries. This study aimed to quantify gross disease burden, expressed as disability-adjusted life years (DALYs), across 25 conditions in a large rural Thai older adult population. Particular emphasis was placed on polypharmacy, multimorbidity, and potentially inappropriate medications, alongside the identification of disease clustering patterns to inform integrated care planning. Population-based cross-sectional study of 587,905 older adults (aged ≥ 60 years) from 46 secondary hospitals in the 8th Health Service Region of northeastern Thailand. DALYs were calculated using Global Burden of Disease 2017 methodology. Polypharmacy was defined as concurrent use of ≥ 5 unique active pharmaceutical ingredients (APIs) for ≥ 90 consecutive days, assessed over both 2-year and 3-year lookback windows. Multimorbidity was defined as ≥ 2 chronic conditions. Potentially inappropriate medications were assessed using 2019 American Geriatrics Society Beers Criteria and Thai Rational Drug Use (RDU) criteria. DALY estimates represent gross population-level burden attributable to each condition or syndrome, without adjustment for co-occurring conditions. Total disease burden was 48.4million DALYs (8,240,612 DALYs per 100,000 population). Diabetes mellitus accounted for the highest burden (16,511,859 DALYs; 2,910,112 per 100,000), followed by hypertension (8,331,200 DALYs; 1,417,720 per 100,000). Polypharmacy affected 59.5% (n = 349,803) contributing 4,035,612 DALYs (686,408 per 100,000), with YLL comprising 54.3% of this burden. Multimorbidity affected 48.6% (n = 285,721) contributing 3,301,572 DALYs. Potentially inappropriate medications were present in 32.1% (n = 188,718). The most common disease clusters were diabetes, hypertension, renal failure and respiratorycardiovascular combinations. Polypharmacy and multimorbidity represent substantial gross population-level burdens in rural Thai older adults. These findings apply specifically to older adults accessing outpatient services at secondary hospitals in the 8th Health Service Region and should not be generalized to the entire rural older adult population. High prevalence of potentially inappropriate medications indicates urgent need for medication optimization interventions. Diabetes emerges as the leading disease burden despite lower prevalence than hypertension, highlighting the importance of DALY-based priority setting. These gross DALY estimates should be interpreted as descriptive measures of population health loss associated with each condition, rather than causal or adjusted effect estimates.

Older adults with heart failure (HF) are at high risk of potentially inappropriate medications (PIMs) during hospital discharge, yet real-world data from Asian populations remain limited. This study aimed to investigate the prevalence, spectrum and predictors of PIMs at discharge among older patients with HF in Eastern China. This retrospective cross-sectional study enrolled 468 patients aged ≥ 65 years with chronic HF hospitalized between 2022 and 2024. PIMs were identified according to 2023 American Geriatrics Society Beers Criteria. The primary outcome was PIM prevalence, and predictors were analyzed using multivariable logistic regression. PIMs are highly prevalent in older patients with HF at discharge. Polypharmacy, atrial fibrillation (AF) and renal impairment are the main risk factors. Targeted medication reconciliation and electronic medical record-based alerts are needed to reduce preventable drug-related harm. The overall prevalence of PIMs at discharge was 87.4% (409/468), with a mean of 2.4 ± 1.8 PIM instances per patient. Three independent predictors were identified: discharge medication count ≥ 7 (aOR = 3.45, 95% confidence interval (CI): 2.10–5.66), AF (adjusted odds ratio [aOR] = 2.98, 95% CI: 1.89–4.68), and eGFR < 45 mL/min/1.73m2 (aOR = 1.74, 95% CI : 1.05–2.88). A synergistic interaction between AF and polypharmacy further elevated PIM risk. Common PIMs included furosemide, rabeprazole and rivaroxaban.

Polypharmacy and potentially inappropriate medications are highly prevalent in primary care and are associated with adverse drug events, reduced adherence, and diminished quality of life. Deprescribing is a key strategy to address these challenges, but its implementation is complex, particularly when long-term preventive medications are involved and decisions are preference-sensitive. Digital tools may support shared decision making in deprescribing, yet many existing tools lack clear implementation orientation. This study describes the iterative refinement of arribaMediQuit, a digital deprescribing tool for primary care, with the aim of improving usability, ethical robustness, and implementation potential. The refinement followed an iterative, participatory development process informed by the Medical Research Council framework for complex interventions and the International Patient Decision Aid Standards. Multiple stakeholder groups were involved, including general practitioners, researchers in health services and pharmacology, members of a patient advisory board, experts in medical ethics, and the original developers of the tool. Regular expert meetings were used to review content, terminology, visual design, decision logic, and deprescribing strategies. Feedback was continuously integrated into successive versions of the tool. The study focused on qualitative refinement rather than outcome evaluation. Key refinements included the development of a dynamic medication database and a structured categorization of medications into three categories (symptomatic, intermediate, and preventive medications) with tailored decision processes. A new linear decision model was introduced for preventive medications to better reflect value-sensitive trade-offs under uncertainty. Terminology and visual elements were revised to align with everyday clinical language and to enhance patient comprehensibility. Ethical considerations, including the communication of benefits, harms, and withdrawal symptoms, were explicitly addressed. Stakeholders also identified potential future uses of the tool, such as educational applications and integration with other deprescribing or medication review tools. The iterative, theory-informed refinement of arribaMediQuit illustrates how shared decision making principles can be operationalized in a deprescribing tool designed for routine primary care. By integrating technical guidance with value-sensitive deliberation and implementation considerations, the tool shows promise for supporting ethically grounded and feasible deprescribing. Future studies will evaluate feasibility, acceptability, and use in routine practice.

Older adults with heart failure (HF) are particularly vulnerable to polypharmacy and potentially inappropriate medication (PIM) use due to multimorbidity, age-related physiological changes, and complex therapeutic regimens. The 2023 American Geriatrics Society (AGS) Beers Criteria provide updated guidance to identify medications that may increase the risk of adverse outcomes in older adults and can be applied to patients with HF. This study aimed to determine the prevalence and patterns of PIM use among older adults with HF and to identify clinical factors associated with increased PIM burden using the 2023 Beers Criteria. This retrospective cross-sectional study included 524 adults aged ≥ 65 years admitted with HF to two hospitals within the Huntsville Hospital Health System between January 2020 and May 2025. Home medications at admission were evaluated according to the 2023 AGS Beers Criteria. PIMs were categorized as generally inappropriate, disease-specific, use with caution, high-risk drug-drug interactions, or medications requiring avoidance or dose adjustment based on renal function. Multivariable negative binomial regression was used to identify predictors of PIM burden defined as the total number of PIMs per patient. Overall, 472 patients (90.1%) were prescribed at least one PIM, and 26.2% of all home medications met Beers Criteria. Among 562 PIMs classified as potentially inappropriate, gastrointestinal (33.8%), cardiovascular (22.6%), and central nervous system agents (17.1%) were the most frequent. Clinically significant drug-drug interactions (n = 165) and renal function-related PIMs (n = 118) were also common. In multivariable analysis, higher PIM burden was independently associated with chronic kidney disease (IRR 1.38, 95% CI 1.20-1.59), depression (IRR 1.29, 95% CI 1.05-1.58), benign prostatic hyperplasia (IRR 1.26, 95% CI 1.03-1.53), and increasing comorbidity burden (IRR 1.04 per additional condition, 95% CI 1.00-1.07). PIM use is highly prevalent among older adults with HF. Targeted medication review-particularly in patients with renal impairment or multiple comorbidities-followed by deprescribing or safer substitutions, represents a key quality-of-care intervention to reduce preventable medication-related harm in this vulnerable population.

Little is known about substitution of alternative medications in the context of deprescribing. The objectives were to: (1) determine the frequency of medication substitutions among those who discontinued a central nervous system (CNS)-active medication, and (2) characterize substitutions as potentially inappropriate (as per the 2023 Beers Criteria) versus not. We conducted a secondary analysis that combined data from the intervention and usual care arms from the STOP-FALLS deprescribing trial that tested a health-system-embedded intervention designed to reduce prescription of CNS-active medications. This analysis focused on participants followed for 360 days following baseline with chronic use of opioids, benzodiazepines, tricyclic antidepressants, skeletal muscle relaxants, or Z-drugs. Discontinuation was defined as the first date when there was no evidence of a prescription fill for 90 days, thus only participants with a discontinuation that occurred in the first 270 days were included. A list of likely alternative treatments was developed for each target medication. A substitution was operationalized as a new alternative medication prescribed during the 30 days prior to or 60 days after discontinuation of a target medication. The study sample included 2182 individuals (average age 70.5 years, 63.1% female). At baseline, a total of 2415 target medications were prescribed, of which 442 (18.3%) were discontinued. Discontinuation rates varied from 122 (8.0%) for users of opioids to 86 (49.7%) for users of skeletal muscle relaxants. Substitutions were made for 42 (9.5%) drug discontinuations. Of these substitutions, 11 of 42 (26.2%) were to a potentially inappropriate medication: tricyclic antidepressants (n = 5), benzodiazepines (n = 3) and hydroxyzine (n = 3). Other common substitutions included gabapentin, selective serotonin norepinephrine reuptake inhibitors, and trazodone. Of medication discontinuations with a substitution, one-quarter were to at least one potentially inappropriate medication. This finding highlights the need for additional guidance for prescribers to ensure safe deprescribing of CNS-active medications.

Pharmaceutical intervention for the reduction of risks associated with medications in patients with liver cirrhosis in primary care.

Deprescribing is a valuable approach to reducing inappropriate medication use, particularly in older adults and patients concurrently using high numbers of medications (polypharmacy). While previous research has focused on specific drug classes or patient populations, the overall effects of deprescribing in a community-based setting remain unclear. This systematic review and meta-analysis aims to assess the effectiveness of deprescribing interventions in community-based settings regarding economic outcomes and patient safety, measured as the reduction of potentially inappropriate medication. We conducted a comprehensive search across Embase, Central, and Medline with studies published prior to 20th April 2025. Data was extracted and narratively summarized according to a standardized protocol, and a meta-analysis was performed with a selection of the included studies. Risk of bias was assessed with the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the ROBINS-I tool for non-randomized controlled trials (NRCTs). The systematic review included 27 studies, of which nine were included in the meta-analysis. The meta-analysis showed significant results, indicating that deprescribing interventions reduced prescribing-related medication use, including potentially inappropriate medications (PIMs) and specific medication types, in community-based settings, with an effect size of -0.3234 (SE = 0.1378). The descriptive outcomes further support the result that deprescribing interventions may lead to a reduction in PIMs. Additionally, eight studies assessing economic outcomes, like cost-effectiveness and cost-utility, consistently found that deprescribing interventions led to healthcare cost savings. This is the first meta-analysis to examine deprescribing in a broad, community-based setting without focusing on a specific patient group or medication type. The meta-analysis confirmed significant effects, and the descriptive findings, along with economic assessments, further support the benefits of deprescribing. However, further studies are needed to address remaining uncertainties regarding long-term outcomes and the scalability of deprescribing strategies across diverse healthcare systems.

Alzheimer's disease and related dementias (ADRD) are frequently associated with behavioral and psychological symptoms of dementia (BPSD), which complicate care, increase medication exposure and cognitive iatrogenic risk. The mobile team for ADRD (MTAD) provides therapeutic recommendations for acute cases following home interventions. This study evaluated the theoretical impact of MTAD medication recommendations on medication exposure in community-dwelling older patients with neurocognitive disorders (NCD) and BPSD. This retrospective single-center study included older patients with NCDs visited by MTAD. Medication exposure was evaluated theoretically, assuming full implementation of MTAD medication recommendations, based on medication number, prevalence of potentially inappropriate medications (PIMs) identified using the EU(7)-PIM list, and sedative/anticholinergic burden quantified by the Drug Burden Index (DBI). MTAD medication recommendations were classified. Among 246 patients (mean age 83.9 years), MTAD recommendations would result in a significant reduction in PIMs per patient (0.91 versus 0.79, p < 0.001), with a significant increase in the overall and sedative DBI (0.55 versus 0.74, p < 0.001; 0.46 versus 0.65, p < 0.001, respectively), and number of prescribed medications (6.5 versus 6.9, p < 0.001), without change in the anticholinergic DBI (0.25 versus 0.26, p = 0.206). A total of 337 recommendations were issued, mainly additions (51%) and discontinuations (23%), primarily targeting psychotropics. The theoretical implementation of MTAD recommendations for older patients with BPSD could reduce exposure to PIMs and may lead to an increased use of sedatives. However, further efforts are needed to optimize somatic treatments and minimize iatrogenic risks through comprehensive medication reviews.

Potentially inappropriate medications and geriatric syndromes in hospitalised older patients in Iran: a cross-sectional study

Polypharmacy is a growing health care concern that is ameliorated through deprescribing, the process of safely removing inappropriate medications. Despite the proven benefits of deprescribing, formal deprescribing education in the health professions in the United States, including interprofessional deprescribing activities, is limited. A deprescribing interprofessional educational (IPE) simulation activity was conducted with 52 third- and fourth-year health professions students to improve their understanding of deprescribing and communication among the interprofessional health care team. The virtual simulation featured prebriefing, an unfolding case study, and debriefing. In total, 21 MD students, 20 PharmD (Doctor of Pharmacy) students, and 11 DNP (Doctor of Nursing Practice) and FNP (Family Nurse Practitioner) students participated in the IPE simulation activity. A retrospective pre/post survey was administered, with 49 students (94%) responding. Participants provided positive feedback about the simulation, indicating that they rated the activity highly, valued the unfolding case study used, and were able to consolidate their learning on deprescribing. IPE activities are a promising avenue for deprescribing education.

Frailty is a multidimensional syndrome associated with increased vulnerability to stressors, chronic disease exacerbations, hospitalizations, and disability. Polypharmacy, often defined as the chronic use of five or more medications, is closely and bidirectionally related to frailty. In this context, medication review is a potential strategy to improve health outcomes and slow down the frailty process by optimizing pharmacological treatments. This study aims to evaluate the impact of a geriatrician-led medication review, integrated within primary care (+ AGIL Barcelona program) on polypharmacy and medication adequacy in older adults. We evaluated the effect of the + AGIL Barcelona program on medication adequacy. The + AGIL is a multidisciplinary and multicomponent intervention aimed at promoting healthy aging, based on a comprehensive geriatric assessment and a 10-week structured exercise program, nutritional counseling, medication review, and healthy lifestyle promotion tailored to the individual's needs. Based on patient's frailty status, comorbidities, and preferences, geriatricians revised the medications, and the modifications were discussed with the participants' primary care physician, and in selected cases, with a clinical pharmacist. Baseline and three-month follow-up data were collected, including quantitative polypharmacy prevalence, and potentially inappropriate medications (PIMs), according to the EU(7)-PIM list. Subgroup analyses were based on Clinical Frailty Scale scores. The study included 173 community-dwelling older adults (mean age: 81.2years - SD: 5.7; 68.8% women). At baseline, polypharmacy was prevalent (84.4%), with 59.5% of participants receiving at least one PIM. After three months, a slight reduction in the mean number of medications per patient was observed (7.6 to 7.4, p = 0.051). Reduction of number of PIMs was also observed (1.0 to 0.9 per patient, p = 0.011), particularly in those medications affecting the nervous (from 30.1% to 24.3% in the sample, p = 0.025) and genitourinary (from 6.9% to 4.6%, p = 0.046) systems. After stratifying by frailty, a consistent trend was observed overall and especially among non-frail and vulnerable groups. While the + AGIL Barcelona program had a limited quantitative impact on polypharmacy, it significantly reduced PIMs' use, particularly in nervous system-acting medications, which are involved in increased risk of falling and cognitive impairment in older adults. The study highlights the importance of medication review in multidimensional frailty management, although future research with larger samples and standardized medication review protocols is needed.

Impact of Self-Reported Patient-Provider Communication on the Use of High- and Low-Value Care Among U.S. Adults.

Polypharmacy and potentially inappropriate medications in patients requiring palliative care in hospitals and nursing homes: Evidence from a Ligurian point-prevalence multicenter study.

ABSTRACTAimTo examine how medication burden varies across frailty stages in hospitalized older adults, with a focus on potential nonlinear associations:MethodsWe analyzed a multicenter cohort of hospitalized adults aged ≥ 65 years. Frailty was assessed using the preadmission Clinical Frailty Scale (CFS). Associations between CFS and total medication count, potentially inappropriate medication (PIM) count, and anticholinergic burden (Japanese Anticholinergic Risk Scale) were evaluated using restricted cubic spline models adjusted for age, sex, and Charlson Comorbidity Index. Primary analyses were conducted in participants with complete data (n = 1075).ResultsCFS showed significant associations with all medication‐related indicators (all overall p < 0.05), with evidence of nonlinearity for medication count (p < 0.0001) and PIM count (p = 0.024). Medication burden increased with worsening frailty, with the steepest rise observed in moderate frailty, followed by attenuation in more severe frailty. Across all indicators, adjusted curves suggested a consistent transition around CFS 5–6. These patterns were independent of age, sex, and comorbidity burden.ConclusionsMedication burden is strongly and nonlinearly associated with frailty in hospitalized older adults. These stage‐dependent patterns suggest that moderate frailty may represent a window for targeted medication review and deprescribing, supporting frailty‐stratified approaches to medication management in acute care.

This study aimed to evaluate the incidence, associated risk factors, time course, and predictive performance of kidney function estimation equations for hyperfiltration in critically ill older adults. This retrospective observational study evaluated 325 patients (median age, 76 years) admitted to the intensive care unit (ICU) of a tertiary-care university hospital, for a total of 2934 patient-days. The hyperfiltration threshold was defined using measured creatinine clearance (Clcr) > -0.883 × age + 167.398. Independent factors associated with hyperfiltration were identified via a multivariable logistic regression model, and time to onset and duration were evaluated using Kaplan-Meier curves. Additionally, the predictive performance of the measured Clcr was assessed using the Cockcroft-Gault equation. Bias was analyzed using the Bland-Altman analysis, and accuracy was evaluated using the percentage within 30% of the measured Clcr (P30). Hyperfiltration occurred in 56% of the patients. Risk factors included male sex, high body mass index, trauma-related admission, vasopressor use, and low serum creatinine levels. The median time from ICU admission to hyperfiltration onset was 5 days, and the median duration of hyperfiltration episodes was 8 days. The Cockcroft-Gault equation substantially underestimated measured Clcr in patients with hyperfiltration. Even among those whose measured Clcr did not meet the conventional augmented renal clearance (ARC) threshold (> 130 mL/min), the equation exhibited a clinically significant negative bias (-35 mL/min) with limited accuracy (P30: 39%). This underestimation was even more pronounced in patients meeting the ARC criteria (bias: -62 mL/min; P30: 27%). Hyperfiltration is highly prevalent in critically ill older adults. The Cockcroft-Gault equation substantially underestimated actual kidney function, even without meeting the ARC criteria. Continuous monitoring of the measured Clcr is recommended to avoid inappropriate medication dose reductions due to underestimation.

Effectively identifying individuals exposed to drug underuse, overuse and potentially inappropriate medication (PIM) in older adults is essential for minimizing preventable drug-related harms. We analysed data from 54,296 individuals aged 60-74 years from the German National Cohort (NAKO). We assessed the frequency of PIM, untreated conditions (medication and vaccination underuse) and medications without indication (overuse) utilizing the Fit fOR The Aged (FORTA) list. Factors associated with PIM, medication overuse and underuse were identified by multivariable logistic regression models. The frequency of PIM, underuse and overuse of medications was 26.1%, 19.1% and 23.6%, respectively. In participants with available vaccination information, 90.6% and 62.7% did not have the recommended pneumococcal and annual influenza virus vaccinations, respectively. Parkinson's disease, arterial hypertension, epilepsy and depression were strongly associated with PIM use, with 16.2-, 4.5-, 4.3- and 2.1-fold increased odds, respectively. Osteoporosis, atrial fibrillation, Parkinson's disease and chronic obstructive pulmonary disease were identified as particularly strongly associated with underuse, with 9.5-, 6.1-, 2.6- and 2.0-fold increased odds, respectively. Depression and epilepsy were the most prominent factors associated with overuse (1.6- and 1.5-fold increased odds). PIM and medication overuse, as well as drug and vaccine underuse, are very common among older German individuals. Comprehensive medication reviews are needed to improve medication quality. This work identifies people with specific characteristics who would benefit the most and could be prioritized for medication reviews.

Barriers and facilitators to deprescribing in older adults: an integrative review.