Scoping Review Maps Global Patterns of Drug Over- and Underprescribing

This scoping review synthesizes heterogeneous global literature into a structured framework showing that high-risk older adults are frequently underprescribed evidence-based therapies while low-risk patients are overtreated across cardiovascular, pulmonary, and metabolic conditions.

prescribing appropriatenessdeprescribingpolypharmacyantimicrobial stewardshipSABAinhaled corticosteroidsLAMAanticoagulantsopioidsgeriatricsscoping reviewSTOPP/STARToverprescribingunderprescribing Geriatrics / Geriatric Pharmacy

Background Information

Inappropriate drug prescribing spans cardiovascular to pulmonary diseases.

Inappropriate prescribing can lead to significant patient harm and increased healthcare costs, especially in vulnerable populations such as older adults. The review highlights both underprescription and overprescription across various conditions, like cardiovascular and pulmonary diseases, influenced by systemic and individual factors. Understanding the factors leading to inappropriate prescribing can help pharmacists target interventions to optimize therapy, particularly in high-risk populations. Balancing under- and overprescription requires addressing both individual and systemic healthcare factors.

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Authors: Bindel LJ, Seifert R

Citation: Bindel LJ, Seifert R Global under- and overprescribing of drugs-a scoping review. Naunyn-Schmiedeberg's archives of pharmacology. 2026. doi:10.1007/s00210-026-05910-9

Article Links: PubMed · Journal / DOI

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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