{
  "abstract": "Context\n\nPolypharmacy, commonly defined as the concurrent use of five or more medicines, and excessive polypharmacy, often defined as the use of ten or more medicines, are highly prevalent among older adults with multimorbidity. Although appropriate polypharmacy may be necessary, polypharmacy can be associated with adverse drug reactions, drug-drug interactions, falls, hospitalisation, cognitive impairment, non-adherence, treatment burden and (preventable) harm during transitions of care.Methods\n\nThis narrative review examines medication optimisation in older adults, tracing its evolution from structured medication review, pharmacist-led interventions, explicit prescribing and deprescribing criteria to digital decision support, artificial intelligence (AI)-enabled pharmacovigilance and personalised medication-risk management. European implementation perspectives, with Belgium and Poland as illustrative examples, are used to examine how professional roles, reimbursement mechanisms, clinical tools and health-data infrastructure shape medication safety.Results\n\nThis review integrates geriatric medication optimisation, European implementation experience and AI-enabled pharmacovigilance within a framework linking risk detection, clinical interpretation and treatment optimisation. Current evidence is more consistent for improvements in prescribing quality and medication-related problems than for hard clinical outcomes such as mortality, falls or hospitalisation. AI-supported approaches may improve risk detection and prioritisation, but their clinical value depends on data quality, interoperability, explainability, external validation, human oversight and prospective evidence of patient benefit.Conclusions\n\nFuture geriatric medication safety should combine comprehensive geriatric assessment, explicit clinical criteria, patient-centred deprescribing, pharmacist-led multidisciplinary review, interoperable health data and accountable AI-enabled decision support.",
  "abstract_shown": true,
  "affiliations": [
    "Department for Research Support and Technology Transfer, University of Mons (UMONS), 7000 Mons, Belgium.",
    "Department of Geriatrics, Medical University of Bialystok, Kilinski Str.1, 15-089 Bialystok, Poland.",
    "Unit of Therapeutic Chemistry and Pharmacognosy, Faculty of Medicine, Pharmacy and Biomedical Sciences, University of Mons (UMONS), 7000 Mons, Belgium.",
    "Department of Engineering Innovation Management, Faculty of Engineering, University of Mons, 7000 Mons, Belgium.",
    "Unit of Clinical Pharmacy, Faculty of Medicine, Pharmacy and Biomedical Sciences, University of Mons (UMONS), 7000 Mons, Belgium."
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Rania Aro"
    },
    {
      "affs": [
        1
      ],
      "name": "Zyta Beata Wojszel",
      "orcid": "0000-0002-6472-5241"
    },
    {
      "affs": [
        2
      ],
      "name": "Pierre Duez",
      "orcid": "0000-0002-0484-1478"
    },
    {
      "affs": [
        3
      ],
      "name": "Fabian Lecron"
    },
    {
      "affs": [
        4
      ],
      "name": "Stéphanie Patris",
      "orcid": "0000-0003-0753-5422"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3pq5fav8jjzft.bib",
  "cited_by": 0,
  "doi": "10.3390/healthcare14193240",
  "fulltext_url": "https://europepmc.org/articles/PMC13665473",
  "id": "3pq5fav8jjzft",
  "issns": [
    "2227-9032"
  ],
  "landing_url": "https://europepmc.org/article/MED/42881678",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2717|Pharmaceutical Practices and Patient Outcomes"
    ]
  ],
  "openalex": "W7215085424",
  "pdf_url": "https://europepmc.org/articles/PMC13665473?pdf=render",
  "pmcid": "PMC13665473",
  "pmid": "42881678",
  "published": "2026-10-01",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3pq5fav8jjzft.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42881678",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42881678"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2717|Pharmaceutical Practices and Patient Outcomes",
      "subfield": "general"
    }
  ],
  "title": "A Narrative Review of Medication Optimisation in Older Adults with Polypharmacy: From Structured Medication Review to AI-Enabled Medication Safety.",
  "title_text": "A Narrative Review of Medication Optimisation in Older Adults with Polypharmacy: From Structured Medication Review to AI-Enabled Medication Safety.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/3pq5fav8jjzft",
  "venue": "Healthcare (Basel, Switzerland)",
  "versions": []
}