Challenges and Strategies in Medication Management for Patients With Multiple Comorbidities

Abstract

As the global population ages, polypharmacy-the concurrent use of multiple medications-has become increasingly common among older adults with multiple chronic conditions. While often clinically necessary, polypharmacy is associated with significant challenges, including medication nonadherence, adverse drug events, and increased hospitalizations. This narrative review synthesizes current evidence to explore the burden of polypharmacy, identify barriers to safe medication use, and assess intervention strategies aimed at improving outcomes in older adults. Drawing from diverse sources including clinical trials, observational studies, and policy reports, this review highlights the multifaceted nature of medication management in older adults. Contributing factors to nonadherence include cognitive decline, regimen complexity, low health literacy, and fragmented care. Interventions such as pharmacist-led medication reviews, deprescribing initiatives, motivational interviewing, and digital health tools have demonstrated potential in improving adherence and therapeutic safety. Emerging approaches-including pharmacogenomic-guided prescribing and AI-driven clinical decision support-also offer promising avenues for personalized care. A comprehensive, multidisciplinary framework that incorporates patient-centered communication, integrated care models, and supportive policy infrastructure is essential for addressing the complexities of polypharmacy in older populations. Continued research and collaboration across healthcare disciplines will be critical to translating these strategies into routine practice and enhancing medication safety for this vulnerable demographic.

Keywords: artificial intelligence in healthcare; collaborative approach; deprescribing; digital health education; medication adherence; medication management; multimorbidity management; older adult; pharmacogenomics; polypharmacy.

Figure 1. Polypharmacy management framework

A visual summary of patient-centered strategies to manage polypharmacy in older adults with multimorbidity. Created by the author for this publication. No external sources were used.