Polypharmacy in older adults: a global and Latin American bibliometric analysis, 2021-2026
Polifarmacia en personas mayores: análisis bibliométrico mundial y latinoamericano, 2021-2026Main Article Content
Introduction: Polypharmacy is operationally defined as the concurrent use of five or more medications. Objective: To characterize, through a comparative bibliometric analysis, the global and Latin American scientific output on polypharmacy in older adults between 2021 and 2026. Materials and methods: A descriptive, comparative bibliometric study based on the Scopus database, involving a multilingual search for terms related to polypharmacy and aging, restricted to articles published between 2021 and 2026. Results: The corpus comprised 6,203 global documents and 378 from Latin America; the region accounted for 6.1% of the total, with production concentrated in Brazil, followed by Mexico, Colombia, Argentina, Chile, and Peru. The United States led the global corpus, accounting for 11.4% of the documents. Furthermore, frailty was the most frequent topic, while adverse drug reactions were the most commonly cited outcome, followed by mortality and hospitalization, both globally and within the Latin American context. Conclusions: Scientific output from Latin America was lower and more geographically concentrated than that of the rest of the world; however, both the global and Latin American bodies of literature prioritized the clinical consequences of polypharmacy, whereas economic burden and deprescribing were represented to a varying and unequal extent.
Introducción: La polifarmacia se define operacionalmente como el uso concurrente de cinco o más medicamentos. Objetivo: Caracterizar, mediante un análisis bibliométrico comparativo la producción científica mundial y latinoamericana sobre polifarmacia en personas mayores entre 2021 y 2026. Materiales y métodos: Estudio bibliométrico, descriptivo y comparativo basado en Scopus, en el cual se ejecutó una búsqueda multilingüe sobre polifarmacia y descriptores de vejez, restringida a artículos publicados entre 2021 y 2026. Resultados: El corpus incluyó 6,203 documentos mundiales y 378 latinoamericanos; la región representó 6.1% del total y concentró su producción en Brasil, seguida de México, Colombia, Argentina, Chile y Perú. Por otra parte, Estados Unidos lideró el corpus mundial con 11.4%. Además, la fragilidad fue el tema más frecuente, mientras que las reacciones adversas fueron el desenlace más mencionado, seguidas de mortalidad y hospitalización en ambas escalas. Conclusiones: La producción latinoamericana fue menor y geográficamente más concentrada que la mundial, pero ambas escalas priorizaron las consecuencias clínicas de la polifarmacia, mientras que la carga económica y la deprescripción mostraron una presencia desigual.
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Castillo M, Yamada G, Diez AV, Alfaro T, Flores S, Barrientos T, et al. Aging and self-reported health in 114 Latin American cities: gender and socio-economic inequalities. BMC Public Health. 2022;22(1). https://doi.org/10.1186/s12889-022-13752-2
Ibanez A, Maito M, Botero F, Fittipaldi S, Coronel C, Migeot J, et al. Healthy aging meta-analyses and scoping review of risk factors across Latin America reveal large heterogeneity and weak predictive models. Nature aging. 2024;4(8):1153-65. https://doi.org/10.1038/s43587-024-00648-6
Nicholson K, Liu W, Fitzpatrick D, Hardacre KA, Roberts S, Salerno J, et al. Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review. The lancet Healthy longevity. 2024;5(4):287-96. https://doi.org/10.1016/S2666-7568(24)00007-2
Rezende CG, Chocano PO, Sadlon A, Theiler R, Orav JE, Vellas B, et al. Prevalence of polypharmacy in community-dwelling older adults from seven centres in five European countries: a cross-sectional study of DO-HEALTH. BMJ open. 2022;12(4). https://doi.org/10.1136/bmjopen-2021-051881
Toh JJY, Zhang H, Soh YY, Zhang Z y Wu XV. Prevalence and health outcomes of polypharmacy and hyperpolypharmacy in older adults with frailty: a systematic review and meta-analysis. Ageing Research Reviews. 2023;83. https://doi.org/10.1016/j.arr.2022.101811
Daunt R, Curtin D y O'Mahony D. Polypharmacy stewardship: a novel approach to tackle a major public health crisis. The Lancet Healthy Longevity. 2023;4(5):e228-e35. https://doi.org/10.1016/S2666-7568(23)00036-3
American Geriatrics Society. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society. 2023;71(7):2052-81. https://doi.org/10.1111/jgs.18372
De las Salas R, Vaca C, Eslava J, Torres C y Figueras A. Tackling potentially inappropriate prescriptions in older adults: development of deprescribing criteria by consensus from experts in Colombia, Argentina, and Spain. BMC geriatrics. 2023;23(1). https://doi.org/10.1186/s12877-023-04271-9
Mascarelo A, Sant’Anna AL, Regina S, Doring M y Rodrigues M. Incidence and risk factors for polypharmacy among elderly people assisted by primary health care in Brazil. BMC geriatrics. 2023;23(1). https://doi.org/10.1186/s12877-023-04195-4
Alves K, Crispim A, Mara J y Bof F. Polypharmacy among older adults in Brazil: association with sociodemographic factors and access to health services. Dialogues in Health. 2022;1. https://doi.org/10.1016/j.dialog.2022.100078
O’Mahony D, Cherubini A, Guiteras AR, Denkinger M, Beuscart JB, Onder G, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. European geriatric medicine. 2023;14(4):625-32. https://doi.org/10.1007/s41999-023-00777-y
Delara M, Murray L, Jafari B, Bahji A, Goodarzi Z, Kirkham J, et al. Prevalence and factors associated with polypharmacy: a systematic review and meta-analysis. BMC geriatrics. 2022;22(1). https://doi.org/10.1186/s12877-022-03279-x
Ibrahim K, Cox NJ, Stevenson JM, Lim S, Fraser SD y Roberts HC. A systematic review of the evidence for deprescribing interventions among older people living with frailty. BMC geriatrics. 2021;21(1). https://doi.org/10.1186/s12877-021-02208-8
Sánchez J, Correia RB, Camacho M, Lepore R, Mattos MM, Rocha LM y Valencia A. Prevalence and differences in the co-administration of drugs known to interact: an analysis of three distinct and large populations. BMC medicine. 2024;22(1). https://doi.org/10.1186/s12916-024-03384-1
Osanlou R, Walker L, Hughes DA, Burnside G y Pirmohamed M. Adverse drug reactions, multimorbidity and polypharmacy: a prospective analysis of 1 month of medical admissions. BMJ open. 2022;12(7). https://doi.org/10.1136/bmjopen-2021-055551
Li Y, Zhang X, Yang L, Yang Y, Qiao G, Lu C y Liu K. Association between polypharmacy and mortality in the older adults: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics. 2022;100. https://doi.org/10.1016/j.archger.2022.104630
Dos Santos AB, Nunes MC, Gabriele L, Arlindo C, Paulista MR y De Santa ET. Polypharmacy associated with low functional capacity in older adults: results from the SHIP-Brazil Study. Revista Brasileira de Geriatria e Gerontologia. 2025;28. https://doi.org/10.1590/1981-22562025028.240098.en
Alves K, Antônio E, De Oliveira YA y Bof F. Effect of polypharmacy and fall-risk-increasing drugs (FRIDs) on falls among Brazilian older adults: the SABE cohort study. Archives of gerontology and geriatrics. 2023;115. https://doi.org/10.1016/j.archger.2023.105127
Hernández SK, Garrido AG, Lugo R, Avila A, Chim R y Gutiérrez AL. Characterization of polypharmacy and potential drug–drug interactions in Mexican older adults with cognitive decline. Geriatric Nursing. 2026;73. https://doi.org/10.1016/j.gerinurse.2026.104291
Pu J, Zhong Q, Li S y Zhou B. Bibliometric analysis of polypharmacy in elderly patients with chronic comorbidities from 2013 to 2023. Medicine. 2026;105(1). https://doi.org/10.1097/MD.0000000000043208
Al-Taani GM, Al-Azzam SI, Alzoubi KH, Sweileh WM y Muflih S. Polypharmacy in the elderly: A bibliometric and visualization analysis. Electronic Journal of General Medicine. 2024;21(1). https://doi.org/10.29333/ejgm/13901
Jungo KT, Salari P, Meier R, Bagattini M, Spruit M, Rodondi N, et al. Cost-effectiveness of a medication review intervention for general practitioners and their multimorbid older patients with polypharmacy. Socio-Economic Planning Sciences. 2024;92. https://doi.org/10.1016/j.seps.2024.101837
Cosgrave N, Frydenlund J, Beirne F, Lee S, Faez I, Cahir C y Williams D. Hospital admissions due to adverse drug reactions and adverse drug events in older adults: a systematic review. Age and ageing. 2025;54(8). https://doi.org/10.1093/ageing/afaf231
Thompson W y McDonald EG. Polypharmacy and deprescribing in older adults. Annual review of medicine. 2024;75(1):113-27. https://doi.org/10.1146/annurev-med-070822-101947
Hung A, Kim YH y Pavon JM. Deprescribing in older adults with polypharmacy. BMJ. 2024;385. https://doi.org/10.1136/bmj-2023-074892
Patterson SM, Cadogan CA, Kerse N, Cardwell CR, Bradley MC, Ryan C y Hughes C. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane database of systematic reviews. 2014(10). https://doi.org/10.1002/14651858.CD008165.pub3
McCarthy C, Clyne B, Boland F, Moriarty F, Flood M, Wallace E, et al. GP-delivered medication review of polypharmacy, deprescribing, and patient priorities in older people with multimorbidity in Irish primary care (SPPiRE Study): a cluster randomised controlled trial. PLoS medicine. 2022;19(1). https://doi.org/10.1371/journal.pmed.1003862
Jungo KT, Ansorg AK, Floriani C, Rozsnyai Z, Schwab N, Meier R, et al. Optimising prescribing in older adults with multimorbidity and polypharmacy in primary care (OPTICA): cluster randomised clinical trial. BMJ. 2023;381. https://doi.org/10.1136/bmj-2022-074054
Carollo M, Crisafulli S, Vitturi G, Besco M, Hinek D, Sartorio A, et al. Clinical impact of medication review and deprescribing in older inpatients: a systematic review and meta‐analysis. Journal of the American Geriatrics Society. 2024;72(10):3219-38. https://doi.org/10.1111/jgs.19035
Green AR, Quiles R, Daddato AE, Merrey J, Weffald L, Gleason K, et al. Pharmacist‐led telehealth deprescribing for people living with dementia and polypharmacy in primary care: a pilot study. Journal of the American Geriatrics Society. 2024;72(7):1973-84. https://doi.org/10.1111/jgs.18867
Camargo C, Fortunato C, Rodrigues SR y Alves R. Prevalence and factors associated with multimorbidity in adults in Brazil, according to sex: a population-based cross-sectional survey. Frontiers in public health. 2023;11. https://doi.org/10.3389/fpubh.2023.1193428
Lakra K, Pandey M, Meher S, Panda BK, Meher RK, Panigrahi D, et al. Economic burden of multimorbidity and polypharmacy among geriatric patients: a single-center experience from Odisha, India. Cureus. 2024;16(11). https://doi.org/10.7759/cureus.74752
Aro R, Wojszel ZB, Duez P, Lecron F y Patris S. A Narrative Review of Medication Optimisation in Older Adults with Polypharmacy: From Structured Medication Review to AI-Enabled Medication Safety. Healthcare. 2026;14(19). https://doi.org/10.3390/healthcare14193240