A case study of polypharmacy management in nine European countries

A case study of polypharmacy management in nine European countries

Single disease state led evidence-based guidelines do not provide sufficient coverage of issues of multimorbidities, with the cumulative impact of recommendations often resulting in overwhelming medicines burden. Inappropriate polypharmacy increases the likelihood of adverse drug events, drug interactions and non-adherence.

SIMPATHY project: stimulating innovation management of polypharmacy and adherence in the elderly
Funding Body
European Commission
Award Value
Start Date
1 June 2015
End Date
31 May 2017
2 years
Areas covered

A detailed description of a pan-European initiative, ‘Stimulating Innovation Management of Polypharmacy and Adherence in the Elderly, SIMPATHY’, which is a project funded by the European Commission to support innovation across the European Union. This includes systematic review of the literature aiming to summarise and review critically current policies and guidelines on polypharmacy management in older people. The policy driven, evidence-based approach to managing inappropriate polypharmacy in Scotland is described, with consideration of a change management strategy based on Kotter’s eight step process for leading sustainable change.

Expert opinion

The challenges around promoting appropriate polypharmacy are on many levels, primarily clinical, organisational and political, all of which any workable solution will need to address. To be effective, safe and efficient, any programme that attempts to deal with the complexities of prescribing in this population must be patient-centred, clinically robust, multidisciplinary and designed to fit into the healthcare system in which it is delivered.

  • SIMPATHY consortium (including Stewart D, MacLure K). Polypharmacy management by 2030: a patient safety challenge The SIMPATHY consortium, 2017. ISBN: 978-989-207482.
  • Stewart D, Gibson-Smith K, MacLure K, Mair A, Alonso A, Codina C, et al. A modified Delphi study to determine the level of consensus across the European Union on the structures, processes and desired outcomes of the management of polypharmacy in older people. PLoS ONE 2017;12(11):e0188348. doi:10.1371/journal.pone.0188348
  • Stewart D, Mair A, Wilson M, Kardas P, Lewek P, Alonso A, McIntosh J, MacLure K & SIMPATHY consortium. Guidance to manage inappropriate polypharmacy in older people: systematic review and future developments. Expert Opinion on Drug Safety 2017;16(2);203-213. doi:10.1080/14740338.2017.1265503

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