Structured medication reviews for adults with multimorbidity and polypharmacy in primary care: a systematic review

Abstract: Structured medication reviews (SMRs) in primary care offer a patient-centred approach to optimising medicines for adults with multimorbidity and polypharmacy, but their effect on endpoint outcomes is not yet well-established. This review summarises their impact on these outcomes and on medicines optimisation, while also highlighting common delivery methods (in-person or remote).

Design

Systematic review using narrative synthesis.

Data sources

Ovid MEDLINE, Ovid EMBASE, Web of Science and CINAHL via OVID were searched for studies published between January 1997 and August 2025. Eligibility criteria: Studies of adults with multimorbidity and polypharmacy receiving an SMR in primary care, compared with usual care. Randomised controlled trials, non-randomised controlled trials, cohort and cross-sectional designs were eligible. Data extraction and synthesis: Two reviewers independently screened studies; one reviewer extracted data and a second verified them. Study quality was assessed using the National Heart, Lung, and Blood Institute quality assessment tools. Findings were synthesised narratively.