Operationalizing AI-Assisted Polypharmacy Review in Post-Acute and Long-Term Care: A 4Ms-Based, NP-Led Workflow

Polypharmacy in post-acute and long-term care (PA/LTC) is common and is associated with falls, delirium, hospitalization, functional decline, and mortality. In these settings, clinicians must identify drug-drug interactions (DDIs), potentially inappropriate medications (PIMs), renal dosing concerns, and medication contributors to new symptoms under time pressure and during frequent care transitions. We describe a nurse practitioner–led, 4Ms-aligned workflow in which artificial intelligence (AI) is used only for preliminary signal generation and triage, followed by mandatory verification using authoritative medication information resources and pharmacist review in predefined high-risk situations.