Polypharmacy in older adults in Brazilian Primary Health Care: an integrative review

Abstract

Introduction: Population aging in Brazil, intensified over recent decades, has increased the prevalence of chronic non-communicable diseases. This scenario has contributed to the rise of polypharmacy among older adults, particularly in Primary Health Care (PHC), where comprehensive care is essential. Objective: This study aimed to synthesize evidence on the use and impacts of polypharmacy among older adults receiving primary health care in Brazil. Methods: This is an integrative literature review conducted in the PubMed, Medline, LILACS, SciELO, Embase, and ScienceDirect databases, covering the period from 2015 to 2025. Controlled descriptors based on Health Sciences Descriptors (DeCS), Medical Subject Headings (MeSH), and Emtree were used for the searches. Results: A total of seven studies were included. The prevalence of polypharmacy ranged from 19.2% to 57.7%, predominantly among women with multimorbidity and using medications for cardiovascular disorders. Polypharmacy was strongly associated with adverse health outcomes, such as a higher likelihood of potentially inappropriate medication use, poorer sleep quality, impaired gait functionality, and increased risk of falls. Conclusion: The findings suggest weaknesses in medication management and highlight the need for more rigorous clinical protocols that incorporate pharmacological surveillance, professional training, and safe therapeutic strategies, promoting a care model focused on older adults and reducing risks associated with excessive medication use.