Safe Prescribing in Older Adults: Is Everything Prescribed Truly Appropriate?

Population aging is a global phenomenon with significant implications for health systems. In particular, some countries in Latin America, Africa, and Asia are facing an accelerated transition toward a super-aged society in less than two decades. This process has been accompanied by a significant increase in the prevalence of chronic diseases, affecting more than 75% of older adults, which leads to a high therapeutic burden and a proportional increase in medication use. In this context, polypharmacy is defined as the simultaneous use of five or more medications to manage different health conditions. It has become a common practice, with a prevalence ranging from 29% to 75% depending on the clinical setting. Polypharmacy increases the risk of adverse drug reactions (ADRs), drug interactions, prescribing errors, and avoidable hospitalizations. To mitigate the impact of polypharmacy in older adults, specific clinical tools such as the Beers and STOPP/START criteria have been developed. These tools are designed to improve the quality of prescribing and promote safer pharmacotherapy in the geriatric population. This paper aims to describe the impact and current evidence supporting the use of these tools.