Abstract: Objective: To summarize the evidence on management of polypharmacy in frail older adults, in order to provide a basis for scientific medication management. Methods: We systematically searched relevant evidence on polypharmacy management in frail elderly in professional websites and databases at home and abroad from the database's inception to February 29, 2024. Researchers independently evaluated the quality of the literature, extracted and summarized the evidence that met the quality standards. Results: Totally 16 articles were included, including 1 clinical decision-making, 4 guidelines, 4 expert consensus, 4 systematic reviews, 2 randomized controlled trials, and 1 cohort study. Totally 20 pieces of evidence were summarized on the polypharmacy management of frail older adults from 6 aspects: risk assessment, medication adjustment strategy, individualized intervention, precision medicine, supporting and follow-up, and education and training. Conclusion: The evidence from this study can provide evidence-based evidence for medical staff, nursing staff, and family caregivers to manage multiple drug use in frail older adults. Medical staff can combine the wishes of the frail elderly and the specific clinical situation from the six aspects above and use the evidence to improve the problem of polypharmacy in frail older adults.

Key words: frail older adult; polypharmacy; medication management; evidence summary