With the acceleration of aging and the increasing prevalence of polypharmacy, medication discrepancies have become a key issue affecting the safety and efficacy of medication in elderly patients. This paper reviews the current status and assessment tools of medication discrepancies for elderly patients with polypharmacy, elaborates the core concepts of medication discrepancies, analyzes the prevalence, harms and influencing factors of medication discrepancies at home and abroad, and compares in detail the content structure, applicability scenarios, reliability and validity characteristics, and operational strengths and weaknesses of each type of tool. The study finds that the existing tools have their own focus in terms of assessment dimension, applicable population and clinical feasibility, but there are also limitations such as insufficient consideration of cognitive function and medication complexity in elderly patients and a lack of unified gold standard. Finally, this article explores future research directions in this area, such as the development of intelligent assessment systems and the construction of localized assessment tools, to provide clinical practitioners with theoretical references and a practical basis for the rational selection of assessment tools for elderly patients with polypharmacy, the precise identification of medication discrepancies and the development of personalized intervention strategies.

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