SynthesisBMC geriatrics2025
A NASSS framework-guided systematic review and exploratory modelling of digital health interventions for polypharmacy management in older adults.
Synthesis in BMC geriatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Advanced Drug Delivery Strategies in Geriatric Patients with Polypharmacy: Integrating Pharmacokinetics, Personalized Medicine, and Emerging Technologies.Journal of clinical medicine · 2026Review
- Illusory competence vs. real needs a cross-sectional study on the mismatch in Smart Senior Care (SSC) perceptions between nursing students and older adults.Frontiers in public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPolypharmacy is a growing challenge in older adults with multimorbidity, increasing the risk of adverse drug events, hospital admissions, and healthcare utilisation. Technology-supported interventions, such as clinical decision support systems (CDSS) and digital deprescribing tools, offer new opportunities to optimize medication use. However, adoption and sustainability remain variable across healthcare settings. The Non-adoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework offers a valuable lens to evaluate complex digital health interventions targeting medication optimization in older adults.
objectiveThis review systematically examines the adoption, scale-up, and sustainability of technology-supported medicines optimization interventions for older adults, guided by the NASSS framework.
methodsA systematic search was conducted across Scopus, PubMed, Cochrane Library, and CINAHL. After screening and eligibility assessment, 30 studies were included. A narrative synthesis was performed, mapping intervention characteristics and outcomes to NASSS domains. An exploratory predictive modelling, including decision tree analysis, were used to identify factors influencing intervention success. This review was registered with PROSPERO (CRD420251006170).
resultsThe included studies evaluated diverse interventions such as CDSS, electronic prescribing platforms, pharmacist-led deprescribing systems, and telehealth-supported medication reviews. Successful adoption was associated with user-centred technology design, strong clinical leadership, workflow integration, and organizational readiness. Interventions incorporating multidisciplinary collaboration, continuous feedback, and iterative adaptation showed stronger sustainability. Common barriers included technological complexity, poor interoperability, lack of provider engagement, insufficient training, and regulatory constraints. Decision tree analysis identified usability, early stakeholder engagement, organizational alignment, and system adaptability as key factors predicting successful adoption and sustainability.
conclusionThis is the first review to integrate the NASSS framework with decision tree modelling to evaluate technology-supported medicines optimization for older adults with multimorbidity and polypharmacy. The findings emphasize that successful implementation requires a formative, contextually sensitive approach that addresses technological, organizational, and policy-level complexities.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.