[Periodical medication review: bigger and better?]

The Netherlands' practice guideline 'Polypharmacy in older people' (2012) proposed selecting patients who would benefit from a periodical medication review. The guideline committee made it clear that firm evidence supporting selection was lacking, and recent studies evaluating the effects of medication review on relevant patient-related outcomes have failed to show a positive effect on almost any of these outcomes. Regulatory authorities have advised expanding the target population for medication review. We have to conclude, however, that rather than implementing medication reviews across a broad population of older people, many with a low risk of adverse events, it may be more cost-effective to limit this potentially useful but time-consuming intervention to a more select population who would benefit the most from it.