Effect of a pharmacist medication review in elderly patients discharged from the hospital

摘要

During hospital admission, several changes in a patient's drug regimen are often introduced. After discharge, patients frequently do not know which drugs to take, and 20% of the patients experience an adverse event. Medication review is a successful intervention to improve medication safety. We studied the effect of medication review consisting of medication analysis, treatment analysis, patient interview, and counseling by community pharmacists and pharmacy technicians on the occurrence of drug-related problems (DRPs) among elderly patients discharged from the hospital.