title: [Effects of a structured medication review by geriatrician and clinical pharmacologist on appropriateness of pharmacotherapy in frail elderly inpatients].
abstract: OBJECTIVE
  To study the results of a structured medication review of geriatric inpatients by both geriatrician and hospital pharmacist/clinical pharmacologist.
  
  
  METHODS
  Patients who were present at the geriatric ward were eligible for a review of their medication and medical problems using a screening form. Recommendations and questions following these forms were subsequently discussed in the gerontopharmacologic meeting ('GFO') held every two weeks.
  
  
  RESULTS
  In a 30 month-period 44 GFO's were held during which 184 patients were discussed. A total of 206 recommendations were made and 115 questions were asked. Of the recommended interventions,134 (65%) were accepted by the geriatrician. To stop a medication (64/206), to change the dosage of a medication (60/206) and to switch to another medication (44/206) were the types of interventions most accounted for.
  
  
  CONCLUSIONS
  Structured medication review led to a substantial number of medication changes in geriatric inpatients. Nearly two-thirds of the recommended interventions were accepted by the geriatricians. Seventy-two recommendations (35%) were not implemented due to logistic or patient-related reasons.
authors.affiliation: Medisch Centrum Leeuwarden, afdeling Klinische Farmacologie.
authors.forename: K N
authors.initials: KN
authors.lastname: van Dijk
authors.forename: D Z B
authors.initials: DZ
authors.lastname: van Asselt
authors.forename: D
authors.initials: D
authors.lastname: Vogel
authors.forename: C S
authors.initials: CS
authors.lastname: van der Hooft
authors.forename: E N
authors.initials: EN
authors.lastname: Van Roon
authors.forename: J R B J
authors.initials: JR
authors.lastname: Brouwers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D004344:Drug Incompatibility; D004347:Drug Interactions; D017723:Drug Utilization Review / Q000379:methods*; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control; D010607:Pharmacy Service, Hospital / Q000592:standards*; D055656:Prescriptions / Q000592:standards* / Q000706:statistics & numerical data