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Polypharmacy and the use of potentially inappropriate medications (PIMs) remain critical
national practice problems a9ecting older adults and palliative care patients. Pharmacist-
led interventions have been increasingly studied as strategies to improve medication
safety, optimize prescribing, and enhance patient outcomes. Two recent quantitative
studies provide valuable insights into how pharmacists can be e9ectively integrated into
care models to address these issues.
Both Chess-Williams, Broadbent, and Hattingh (2024) and Kimura et al. (2022)
demonstrate that pharmacist-led interventions significantly contribute to medication
safety in populations at high risk for polypharmacy. Both studies found that systematic
pharmacist review, guided by validated tools such as STOPP/FRAIL or STOPP-J,
successfully identified a large number of potentially inappropriate medications (PIMs).
Importantly, prescribers demonstrated a high level of acceptance of pharmacist
recommendations—100% in the community-based palliative telehealth study (Chess-
Williams et al., 2024) and 91% in the hospital-based inpatient study (Kimura et al., 2022).
These findings underscore the consistent role of pharmacists in facilitating deprescribing,
reducing medication burden, addressing medication-related problems, and improving
patient and caregiver education. Collectively, they reinforce the feasibility and clinical
relevance of pharmacist integration into multidisciplinary care models.
At the same time, di9erences in study design, populations, and outcome measures
highlight complementary insights. Chess-Williams et al. (2024) focused on 95 older adults,
primarily cancer patients in palliative telehealth care, emphasizing types of pharmacist
recommendations but without measuring clinical outcomes such as readmissions or
hospitalizations. In contrast, Kimura et al. (2022) examined 544 older inpatients in a
hospital setting, reporting significant reductions in medication counts at discharge but no
change in 30- or 90-day readmission rates. Together, these studies suggest that pharmacist
involvement consistently improves identification and correction of PIMs, yet further
research is needed to establish whether these improvements translate into sustained long-
term outcomes such as improved quality of life and reduced healthcare utilization. The
collective findings a9irm pharmacist-led medication review as a practical, widely
accepted, and e9ective strategy for addressing inappropriate prescribing across diverse
healthcare contexts.
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