Alessandro Fiasconaro, Fernando Falo
Elastic traits of the extensible discrete wormlike chain model
Physical review. E
polypharmacy multimorbidity pose escalating challenges despite numerous attempts interventions yet show consistent improvements health outcomes key factor may varied approaches targeting patients intervention explore patients targeted intervention examining literature respect understanding polypharmacy defined identifying problematic polypharmacy practice addressing problematic polypharmacy interventions performed scoping review defined joanna briggs institute focus primary care settings medline embase cumulative index nursing allied health literature cochrane along clinicaltrialsgov sciencegov worldcatorg searched january 2004 february 2024 included articles focus problematic polypharmacy multimorbidity primary care incorporating multiple types evidence reviews quantitative trials qualitative studies policy documents articles focussing single index disease written english excluded performed narrative synthesis comparing themes findings across collective evidence draw contextualised insights conclusions total 157 articles included casefinding methods often rely basic medication counts often five without considering medical history whether individual medications clinically appropriate approaches highlight specific drug indicators interactions potentially inappropriate prescribing failing capture proportion patients fitting criteria different potentially inappropriate prescribing criteria also show significant inconsistencies determining appropriateness medications often neglecting consider multimorbidity underprescribing may hinder identification precise population requiring intervention improved strategies needed target patients polypharmacy consider patient perspectives individual factors clinical appropriateness development crosscutting measure problematic polypharmacy consistently incorporates adjustment multimorbidity may valuable next step address frequent confounding