The purpose of this study is to evaluate the impact of a collaborative approach (geriatric care involving the collaboration with a clinical pharmacist) to optimize the prescription of medicines for elderly inpatients.

Widespread evidence reveals frequent inadequate use of medicines in elderly patients. This includes inappropriate prescribing (overuse, underuse, misuse) that can lead to adverse drug events and drug-related admissions to hospital. In addition, when a patient is transferred from acute care settings to ambulatory care settings, discrepancies in medicines used often occur and can be hazardous.

Despite this, only limited data exist on the effectiveness of optimization strategies targeted at frail elderly inpatients.

Comparison: elderly inpatients receiving geriatric evaluation and management (GEM) care versus elderly inpatients receiving pharmaceutical care in addition to GEM care.

Inclusion Criteria:

• Patient admitted on the acute geriatric unit of the university teaching hospital Mont-Godinne, Belgium

Exclusion Criteria:

• a terminal illness and life expectancy of less than 3 month
• expected length of stay of 2 days or less
• transfer from another unit where the patient had already been cared for by a GEM team
• refusal to participate
• inclusion during previous admission
• no time for the clinical pharmacist to compound the abstracted chart within 3 days of admission