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Polypharmacy in old age: structured medication review in the pharmacy

Polypharmacy in older patients is everyday pharmacy business. This article examines the clinical risks such as anticholinergic burden and fall risk and presents deprescribing tools relevant to practice. It also explains the new tariff structure under LOA V from 2026, which newly regulates medication review and support in the Swiss pharmacy.

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Rosa Berg · May 23, 2026 · 11 min read
Polypharmacy in old age: structured medication review in the pharmacy

Key points

  • Polypharmacy in patients aged ≥65 requires an active risk assessment using the ACB score, a FRID check and PIM lists.
  • A fall should always trigger a complete review of the medication.
  • The weekly dosing system (LOA V) is the new tool reimbursed by compulsory health insurance for ongoing support, while medication reviews will likewise be reimbursed from 2027.
  • OTC sleep aids containing first-generation antihistamines must be critically questioned in older patients.
↓ Case vignette ↓ In brief

85.5% of residents of Swiss homes for the elderly and nursing institutions receive five or more medicines at the same time; among people aged 65 and over living at home the average is 5.6 substances per day. [1,2] In total, almost 7 million people obtained at least one medicine through compulsory health insurance in 2024, on average 20 packs per person per year. [3] Polypharmacy is no longer the exception but everyday pharmacy business — and with the entry into force of LOA V on 1 January 2026, the tariff structure of the corresponding pharmacy service has been reorganised as well.

At a glance

  • Polypharmacy (concurrent use of ≥5 substances) is prevalent in Swiss nursing homes at 85.5% and is associated with hospitalisation and adverse drug reactions. [1,4]
  • Tools of choice 2024–2026: AGS Beers Criteria 2023, STOPP/START version 3 (190 European criteria), PRISCUS 2.0 (177 active substances for the German-speaking area), STOPPFall (EuGMS list for fall-risk medication). [5,6,7,8]
  • An ACB score ≥3 is associated in the ASPREE cohort with an increased risk of dementia (HR 1.36) and ischaemic stroke (HR 1.58); separate evidence documents the association with falls and mortality. [9,10,11]
  • Swiss tariff reality: the polymedication check (position 2090.00) was removed from compulsory health insurance reimbursement on 1 July 2019; since 1 January 2026 the medicine safety check, the patient safety check and the new weekly dosing system (pos. 3007–3009) structure polypharmacy counselling within the tariff. [12,13]
  • OPERAM study (Blum et al., BMJ 2021, Bern among others): structured STOPP/START-based medication review showed a numerically lower — but not statistically significant — rate of drug-related hospitalisations (HR 0.95); from 1 January 2027, medication review and reconciliation will be reimbursed by compulsory health insurance on the basis of the health insurance act revision of 21 March 2025. [14,15]

Clinical background

Polypharmacy is conventionally defined as the concurrent use of five or more substances. [16] It is often medically necessary — for instance in multimorbid older patients — but itself contributes to morbidity: with each additional medicine, the risk of adverse drug reactions, the interaction risk, the fall risk and the hospitalisation rate rise measurably. [4,11]

The Swiss care reality clearly confirms the trend. The nursing home analysis in the Helsana medicines report 2017 (data base 2016) showed: 85.5% of residents received five or more medicines at the same time, on average 9.3 preparations per day. [1] Among people aged 65 and over living at home, the average was 5.6 medicines per day. [1] The Helsana home-care analysis of 2020 (data base 2019) completes the picture: home-care clients obtained on average 16 preparations in parallel; 47.8% showed long-term use of potentially inappropriate medication (PIM), above all hypnotics and anticholinergics. [2] Current Swiss dispensing data for 2024: just under 7 million people obtaining medicines in total, 20 packs per person per year. [3]

What is clinically decisive is not the number as such but the composition of the medication. Anticholinergic substances accumulate their effect; fall-risk-increasing drugs (FRIDs) add up; the risk of adverse interactions grows disproportionately to the number of components. [8,11] Several international consensus documents structure the risk: the AGS Beers Criteria 2023 [5], STOPP/START version 3 [6], PRISCUS 2.0 [7] and the World Guidelines for Falls Prevention and Management 2022. [17]

Swiss specifics: tariff, structures, reimbursement

Three structural changes in the Swiss tariff and reimbursement system are directly relevant to counselling in the pharmacy.

First: the polymedication check (PMC, tariff position 2090.00) has not been a mandatory service under compulsory health insurance since 1 July 2019. The Federal Council excluded the specific LOA tariff position from the tariff agreement, since the tariff partners could not demonstrate a cost-dampening effect. [12,18] In-depth, structured medication reviews have since ceased to be reimbursed as a separate service under compulsory health insurance — a frequent blind spot in industry communication.

Second: with LOA V (in force from 1 January 2026, approved by the Federal Council on 29 October 2025, limited to three years) the tariff structure was reorganised. [13,19] The former medicine check is now called the medicine safety check and is divided into four levels differentiated by effort (new/existing × dispensing category A/B, tariff items 3000.00–3003.00, 1.44–3.63 tax points). The former dispensing check was renamed the patient safety check (tariff item 3004.00, 2.75 TP) and is explicitly linked to keeping a patient file: comedication, intolerances, interactions and known risks are documented and checked in a structured way. A form of systematic interaction and comedication check is thus part of every reimbursed dispensing.

Important for polypharmacy counselling: with LOA V, the weekly dosing system has been included for the first time as a graded tariff position — ordered by a physician and differentiated by the number of medicines: pos. 3007.00 (3–5 medicines, 6.56 TP), pos. 3008.00 (6–8 medicines, 10.94 TP), pos. 3009.00 (9 or more medicines, 15.21 TP). [13] Since January 2026 there is thus a structured polypharmacy support reimbursed by compulsory health insurance for patients taking three or more chronic medicines — provided the medical prescription is in place. Machine blister packing in nursing homes (pos. 3015/3016) is also newly reimbursed.

Practical consequence: an in-depth medication review going beyond the LOA routine check — with a detailed patient conversation, written recommendation to the family doctor, follow-up — remains in 2026 a private service or part of interprofessional programmes (home-care cooperations, nursing home mandates, regular-customer models). The weekly dosing system (3007–3009) is its reimbursed structuring tool for ongoing support.

Third (on the horizon): the health insurance act revision of 21 March 2025 (amendment of articles 25 and 26, second package of cost-dampening measures) creates the legal basis for reimbursing certain pharmacy services independently of the dispensing of medicines. [15,20] The Federal Council’s dispatch specifies the services to be reimbursed: promotion of adherence (project myCare Start), therapy optimisation, medication reviews and medication reconciliation at transitions of care, vaccination and cantonal prevention programmes (HPV, colorectal cancer screening). [20] The expected entry into force is 1 January 2027; the consultation on the health insurance ordinance runs until 12 March 2026. For the pharmacy this means: build structures, regular-customer files and interprofessional contacts now.

What is frequently asked at the counter

Four counselling situations come up particularly often:

1. «My father (85) now has 14 medicines — isn’t that too many?»

The number alone is not a risk — the composition is. Three screenings in five minutes: which substances are anticholinergic (ACB score)? Which promote falls (FRIDs)? Which no longer have a clear current indication (e.g. a PPI for years without documented reflux symptoms, a statin with limited life expectancy)? Where there are substantial findings, arrange an appointment for an in-depth medication review — today as a private service with written feedback to the family doctor, from 1 January 2027 presumably reimbursed by compulsory health insurance.

2. «I can’t sleep at night — do you have something without a prescription?»

First-generation OTC antihistamines (diphenhydramine, doxylamine) have an ACB score of 3 (strongly anticholinergic) and are clinically problematic in people aged 65 and over: they are explicitly listed in the AGS Beers Criteria 2023 and in STOPP/START v3. [5,6] Alternative at the counter: brief sleep hygiene counselling, referral to the family doctor for a structured sleep assessment in chronic insomnia. No OTC dispensing of diphenhydramine or doxylamine without actively pointing out the anticholinergic burden.

3. «I’ve been prescribed diclofenac for my knees — I also take rivaroxaban.»

A clear red flag. NSAIDs plus direct oral anticoagulants (DOACs) increase bleeding risk in a clinically relevant way; STOPP/START v3 explicitly lists this combination as to be avoided. [6] Procedure: feedback to the prescriber with a proposal for an alternative (paracetamol, topical diclofenac, local therapy, if appropriate an intra-articular injection by orthopaedics), documentation in the patient file.

4. «My mother fell last week — she takes lorazepam, mirtazapine and tamsulosin.»

Three classic FRIDs in combination. STOPPFall (Seppala et al. 2021, EuGMS) and the World Guidelines for Falls Prevention and Management 2022 recommend a systematic review of the entire medication after every fall. [8,17] In this constellation: written feedback to the family doctor with a proposal for a structured reduction strategy — taper the benzodiazepine step by step, check the alpha-1 blocker for orthostatic symptoms, review the antidepressant for indication.

Tools: ACB score, FRIDs, PIM lists, deprescribing

Three systematic screenings should be applied in the pharmacy to every patient aged 65 and over with polypharmacy:

Anticholinergic burden (ACB score)

The Anticholinergic Cognitive Burden Score (Boustani et al. 2008, validated in numerous follow-up works including Salahudeen et al. 2015) captures the cumulative anticholinergic burden across all substances. [9,10] In the ASPREE cohort (n = 19,114, median 4.7 years of follow-up) an ACB score ≥3 was associated with an increased risk of dementia (adjusted HR 1.36; 95% CI 1.01–1.84) and ischaemic stroke (adjusted HR 1.58; 95% CI 1.06–2.35). [11] Separate evidence, including from STOPPFall and several systematic reviews, documents the association of anticholinergic burden with falls and increased mortality in the older population. [4,8,17] Frequent drivers at the counter: tricyclic antidepressants (amitriptyline, doxepin), oxybutynin, solifenacin, tolterodine (urological anticholinergics), diphenhydramine, promethazine, hydroxyzine — as well as numerous OTC sleep aids based on diphenhydramine or doxylamine. Practical online calculator: acbcalc.com.

Fall-risk medication (FRIDs / STOPPFall)

The EuGMS STOPPFall list (Seppala et al. 2021) and the European position paper on polypharmacy and FRIDs (van der Velde et al. 2023) classify the most important substance groups: benzodiazepines and Z-drugs, antidepressants (TCAs, SSRIs), antipsychotics, opioids, antiepileptics, antihypertensives with orthostatic risk, alpha-1 blockers and anticholinergic urological agents. [8,21] After every documented fall a systematic medication review is indicated — the Cochrane evidence on the effectiveness of FRID deprescribing as an isolated intervention remains heterogeneous, but its value as a component of a multimodal fall prevention programme is undisputed. [17]

Potentially inappropriate medication (PIM)

Three lists complement one another in practice. The AGS Beers Criteria 2023 (US, J Am Geriatr Soc, 7th update of the list originally published in 1991). [5] STOPP/START version 3 (European, Eur Geriatr Med 2023, 190 criteria — including the START component, which covers not only prescriptions to be avoided but also missing indicated ones). [6] PRISCUS 2.0 (German-language, Dtsch Arztebl Int 2023; 177 active substances/substance classes in the final list, 187 assessed in the Delphi process). [7] For Switzerland, the combination of STOPP/START v3 and PRISCUS 2.0 is particularly practicable, since it covers European prescribing reality and substances in common use in the German-speaking countries.

Deprescribing in practice

Not every PIM has to be stopped immediately — but a structured reduction makes sense. Important substance classes require tapering over weeks or months (benzodiazepines, SSRIs/SNRIs, beta blockers, opioids, glucocorticoids); others can be stopped directly after checking the indication (e.g. a PPI without a current reflux or gastropathy indication, a statin with a very short life expectancy). Evidence-based deprescribing algorithms are made publicly available by the Canadian platform deprescribing.org; the 2023 Cochrane review on anticholinergic deprescribing confirms the reduction of anticholinergic burden as a sensible therapeutic goal. [22,23] The OPERAM study (Bern among others, BMJ 2021) showed: a single CDSS-supported STOPP/START analysis during a hospital stay does reduce the prescribing of potentially inappropriate medicines, without significantly lowering the primary endpoint — drug-related hospitalisations (HR 0.95). [14] The clinical effect probably only unfolds through repeated, interprofessional application over time — exactly the area in which the pharmacy, as a local point of regular contact, can play to its strength.

Practice tool: decision table for polypharmacy at the counter

Sign at the counterWhat to check?ToolRecommendation
Patient ≥65 with ≥5 substancesIs a complete list available?Patient file (LOA V pos. 3004)Create an extended overview, check indications
Patient with ≥3 chronic medicines, adherence problemsWeekly dosing system prescribed?LOA V pos. 3007–3009Suggest a prescription; structured support reimbursed by compulsory health insurance
Fall in the last 12 monthsFRID combination?STOPPFall, World Guidelines 2022Structured feedback to the family doctor, propose a reduction strategy
Complaints of forgetfulness or confusionAnticholinergic burden?ACB score (acbcalc.com)With ACB ≥3, feedback to the family doctor, non-anticholinergic alternatives
Request for an OTC sleep aid at ≥65Other anticholinergic substances already?ACB score, Beers 2023, STOPP/START v3Sleep hygiene counselling, no first-generation antihistamines
PPI for years without current symptomsIs the indication still current?STOPP criterionPropose stopping or tapering over 4–8 weeks
NSAID + DOAC / VKABleeding risk?STOPP/START v3Suggest an alternative (paracetamol, topical, local therapy)
New opioid after a fallExisting FRIDs?STOPPFall + fall historyExplain the fall risk, feedback to the family doctor
Request for an in-depth reviewClarify indication and expectationsPrivate service; from 2027 reimbursed via the health insurance act revisionArrange an appointment, written feedback to the family doctor

Outlook 2026/2027

Three developments will shape the coming two years for polypharmacy counselling in the Swiss pharmacy.

First: the health insurance act revision of 21 March 2025 (amendment of articles 25 and 26 within the second cost-dampening package) opens up, presumably from 1 January 2027, the possibility of billing certain pharmacy services through compulsory health insurance independently of dispensing medicines. [15,20] The new services specifically provided for in the law include, alongside vaccination, explicitly medication reviews, medication reconciliation at transitions of care, therapy optimisation and adherence promotion — with the myCare Start project as an ongoing pilot phase. [20] The consultation on the health insurance ordinance runs until 12 March 2026. Anyone building structured patient files, regular-customer models and written feedback to family practices now will be ready in 2027.

Second: the electronic patient record is being gradually broadened through ongoing revisions and simplifies interprofessional medication reconciliation between family doctor and pharmacy. In the logic of LOA V it complements the patient safety check with a substantially improved data basis.

Third: AI-supported clinical decision support systems (CDSS) for medication review are established in European studies (OPERAM with the STRIPA tool [14]; the Swiss Documedis platform from HCI Solutions) and are increasingly being integrated into pharmacy management software. [24] The central challenge remains avoiding alert fatigue — not every algorithmically generated warning is clinically relevant. Prioritisation by the pharmacist remains indispensable.

Case vignette

CASE VIGNETTE

Ms B., 82 years old, comes to redeem a prescription for tramadol 50 mg, newly prescribed by the emergency department after a fall with a wrist fracture. She seems tired and somewhat slowed.

During the patient safety check (LOA V pos. 3004.00) the pharmacist sees eight regular dispensings in the file: lorazepam 1 mg at night (for years), mirtazapine 30 mg, solifenacin 5 mg, lisinopril 10 mg, atorvastatin 40 mg, pantoprazole 40 mg, a calcium/vitamin D combination — and occasionally diphenhydramine as an OTC «to help her drop off». With the new tramadol, three additional risk dimensions are added: central sedative effect, serotonergic activity (interaction with mirtazapine) and a fall-potentiating effect.

Three systematic findings stand out immediately:

First: the ACB score is estimated at ≥4 (mirtazapine 1, solifenacin 3, occasional diphenhydramine 3, lorazepam with anticholinergic cross-effect). Ms B. is thus in a range in which the risk of dementia and stroke is increased according to the ASPREE cohort; separate evidence also documents an increased fall risk in this range. [11,17]

Second: three classic FRIDs in combination (lorazepam, mirtazapine, solifenacin) — a fourth (tramadol) is now added. The STOPPFall list covers each of these substances. [8]

Third: pantoprazole with an unclear indication. In conversation the pharmacist learns that the pantoprazole was prescribed six years ago because of NSAID therapy — the NSAID therapy ended long ago. A classic STOPP constellation (PPI without a current indication, >8 weeks). [6]

Resolution. The pharmacist dispenses the tramadol with active information about its fall-promoting effect (slowed reaction, orthostatic effect, sedation synergy with lorazepam and mirtazapine). She then writes structured feedback to Ms B.’s family doctor: (1) ACB score ≥4 and the FRID combination as the central risk constellation after the fall; (2) proposal to review the pantoprazole indication and stop it if appropriate; (3) proposal to replace the OTC diphenhydramine use with a non-anticholinergic sleep strategy; (4) offer of a weekly dosing system (LOA V pos. 3008.00, 6–8 medicines) for structured support reimbursed by compulsory health insurance. She documents the intervention in the patient file.

Three take-aways from the case

  1. A fall almost never has just one cause — the medication is partly responsible until it is proved that it is not.
  2. OTC sleep aids based on diphenhydramine or doxylamine are not «harmless» in people aged 65 and over — they are a central switching point of anticholinergic burden.
  3. The weekly dosing system (LOA V pos. 3007–3009) has since January 2026 been the reimbursed structuring tool for ongoing polypharmacy support — provided it is medically prescribed.

In brief

  • Polypharmacy patients aged ≥65 need active risk assessment: ACB score, FRID check, PIM list (Beers/STOPP/PRISCUS).
  • A fall is a trigger for a complete medication review — not only for orthopaedic care.
  • Actively question first-generation OTC antihistamines (diphenhydramine, doxylamine) in people aged ≥65.
  • LOA V pos. 3007–3009 (weekly dosing system, 3–5 / 6–8 / 9+ medicines) has since 1.1.2026 been the reimbursed structuring tool for ongoing polypharmacy support — subject to a medical prescription.
  • From 1.1.2027: medication review and reconciliation will presumably be reimbursed by compulsory health insurance on the basis of the health insurance act revision of 21.3.2025 — build the structures now.
References
  1. [1] Helsana-Gruppe. Helsana-Arzneimittelreport 2017 – Pflegeheim-Auswertung: 85.5% der Bewohner:innen mit ≥5 gleichzeitig bezogenen Medikamenten, im Mittel 9.3 Präparate pro Tag; ≥65-Jährige zu Hause: 5.6 Präparate pro Tag (Datenbasis 2016). Zürich: Helsana; 2017.
  2. [2] Helsana-Gruppe. Helsana-Arzneimittelreport 2020 – Spitex-Schwerpunkt: durchschnittlich 16 gleichzeitig bezogene Präparate, 47.8% Langzeitbezug potenziell inadäquater Medikation (Datenbasis 2019). Zürich: Helsana; 2020.
  3. [3] Helsana-Gruppe. Helsana-Arzneimittelreport 2025: rund 7 Millionen Bezüger:innen 2024, 20 Packungen pro Person und Jahr. Zürich: Helsana; Dezember 2025. Verfügbar unter: reports.helsana.ch/arzneimittelreport2025.
  4. [4] Wang Z, Liu T, Su Q, et al. Prevalence of Polypharmacy in Elderly Population Worldwide: A Systematic Review and Meta-Analysis. Pharmacoepidemiol Drug Saf. 2024;33:e5880. DOI: 10.1002/pds.5880.
  5. [5] By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052–2081. DOI: 10.1111/jgs.18372.
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  8. [8] Seppala LJ, Petrovic M, Ryg J, et al. STOPPFall (Screening Tool of Older Persons Prescriptions in older adults with high fall risk): a Delphi study by the EuGMS Task and Finish Group on Fall-Risk-Increasing Drugs. Age Ageing. 2021;50(4):1189–1199. DOI: 10.1093/ageing/afaa249.
  9. [9] Boustani M, Campbell N, Munger S, Maidment I, Fox C. Impact of anticholinergics on the aging brain: a review and practical application. Aging Health. 2008;4(3):311–320. (Originalpublikation der Anticholinergic Cognitive Burden Scale, ACB-Score.)
  10. [10] Salahudeen MS, Duffull SB, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015;15:31. DOI: 10.1186/s12877-015-0029-9.
  11. [11] Lockery JE, Broder JC, Ryan J, et al; ASPREE Investigator Group. A Cohort Study of Anticholinergic Medication Burden and Incident Dementia and Stroke in Older Adults. J Gen Intern Med. 2021;36(6):1629–1637. DOI: 10.1007/s11606-020-06550-2. (n = 19'114, Median 4.7 Jahre Follow-up; ACB ≥3 vs. 0: Demenz HR 1.36 [95% KI 1.01–1.84], ischämischer Insult HR 1.58 [95% KI 1.06–2.35].)
  12. [12] Schweizerischer Bundesrat. Medienmitteilung vom 26. Juni 2019: Genehmigung Übergangsvertrag LOA IV/1; Ausschluss der Tarifposition 2090.00 «Polymedikations-Check» per 1. Juli 2019. Bern: admin.ch.
  13. [13] pharmaSuisse und prio.swiss. Tarifstruktur-Vertrag LOA V vom 1. Januar 2026, Anhang A (Tarifstruktur), inkl. Tarifziffern 3000.00–3020.00 (Sicherheits-Check Medikament, Sicherheits-Check Patient, Wochen-Dosiersystem 3007–3009, maschinelle Verblisterung 3015/3016). Befristet auf drei Jahre. Verfügbar unter: pharmasuisse.org.
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  17. [17] Montero-Odasso M, van der Velde N, Martin FC, et al; Task Force on Global Guidelines for Falls in Older Adults. World guidelines for falls prevention and management for older adults: a global initiative. Age Ageing. 2022;51(9):afac205. DOI: 10.1093/ageing/afac205.
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  19. [19] pharmaSuisse. Medienmitteilung vom 29. Oktober 2025: Der neue Apothekertarif LOA V wird vom Bundesrat genehmigt – Inkrafttreten 1. Januar 2026. Bern: pharmaSuisse; 2025.
  20. [20] Schweizerischer Apothekerverband pharmaSuisse. Medienmitteilung vom 21. März 2025: Apotheken stärken – Parlament verabschiedet wegweisende KVG-Revision (zweites Massnahmenpaket zur Kostendämpfung, 16 Massnahmen, Inkrafttreten voraussichtlich 1.1.2027; konkrete Leistungen: Impfen, Medikationsanalyse, Medikationsabgleich, Therapieoptimierung, Adhärenzförderung myCare Start, HPV- und Darmkrebsscreening-Programme).
  21. [21] van der Velde N, Seppala LJ, Hartikainen S, et al. European position paper on polypharmacy and fall-risk-increasing drugs recommendations in the World Guidelines for Falls Prevention and Management: implications and implementation. Eur Geriatr Med. 2023;14(4):649–658. DOI: 10.1007/s41999-023-00824-8.
  22. [22] Farrell B, McCarthy L, Thompson W, et al. Deprescribing Guidelines and Algorithms. deprescribing.org – kanadische evidenzbasierte Plattform mit substanzspezifischen Ausschleich-Algorithmen (PPI, Benzodiazepine, Antipsychotika, Statine u.a.).
  23. [23] Taylor-Rowan M, Kraia O, Kolliopoulou C, et al. Anticholinergic deprescribing interventions for reducing risk of cognitive decline or dementia in older adults with and without prior cognitive impairment. Cochrane Database Syst Rev. 2023;12(12):CD015405. DOI: 10.1002/14651858.CD015405.pub2.
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Themen: Medication Counselling & Indications Drug Interactions & Safety Special Patient Groups Polypharmazie LOA V Deprescribing Geriatrie
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Rosa Berg

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