This review highlights the need to develop new methodologies, combining various approaches for decision support system in polypharmacy.Ĭlinical decision-support system Deprescription Drug-related problem Elderly Polypharmacy Potentially inappropriate medication.Ĭopyright © 2022 The Authors. The evaluations performed are minimal (among all the systems identified, only one system has been evaluated according to all the criteria mentioned above) and no machine learning systems and/or conflict management systems were retrieved. A systematic bibliographic search identified 19 systems differing considerably in terms of their technical design (rule-based systems, documentary approach, mixed) outputs (textual report, alerts and/or visual approaches) and evaluations (impact on clinical practices, impact on patient outcomes, efficiency and/or user satisfaction). Most existing reviews have focused mainly on evaluation results, whereas the present review also describes the technical design of these systems and the methodologies for developing and evaluating them.
We present here a scoping review of electronic systems for supporting the management, by healthcare providers, of polypharmacy in elderly patients. These systems differ widely in terms of their technical design, knowledge sources and evaluation methods. Decision-support systems have therefore been developed to automate the execution of these guidelines, or to provide information about drugs adapted to the context of polypharmacy. Therapeutic guidelines for managing polypharmacy in the elderly have been issued, but are highly complex, limiting their use. It can lead to many interactions and adverse drug reactions and is very expensive. Polypharmacy, the consuming of more than five drugs, is a public health problem.
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