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Under-prescription is defined as the omission of a medication that is indicated for the treatment of a condition or a disease, without any valid reason for not prescribing it. The aim of this review is to provide an updated overview of under-prescription, summarizing the available evidence concerning its prevalence, causes, consequences and potential interventions to reduce it. A PubMed search was performed, using the following keywords under-prescription; under-treatment; prescribing omission; older adults; polypharmacy; cardiovascular