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[Stop conducting one-size-fits-all medication reviews in patients with polypharmacy; rather begin with personalized
Marcel G M Olde Rikkert1, C Kramers2,3
1Radboudumc, afd. Geriatrie, Nijmegen.
Abstract:
The negative OPERAM study results, which are in line with recent trials and reviews, warn against expecting positive patient related outcomes from single standardized medication reviews in all patients with polypharmacy admitted to hospital. The big underlying problem is the enormous heterogeneity of patients with polypharmacy. However, it remains possible that a personalized medication review in well selected vulnerable patients can have positive effects, especially if the review is integrated in a linked hospital and general practice medication policy. Thus, there also is sufficient evidence to stop conducting a one size fits all drug review randomized trials on polypharmacy, but we need pragmatic trials with smart selection of patient with polypharmacy-related health problems, whose personalized and transmural medication guidance may still contribute to positive outcomes of integrated care innovations, especially when the outcomes can be personalized as well.
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