This study assessed the impact of clinical pharmacists' consultations on drug regimens, compliance, and health service use of geriatric hospitalized patients (N = 706) discharged on 3 or more medications. Pharmacists consulted with experimental patients at discharge and 3 months thereafter, and with physicians as needed. Controls received usual care. At 6-8 weeks after enrollment, experimental patients were more knowledgeable about regimens than controls. At 12-14 weeks, they were on fewer medications and less complex regimens, and had better compliance scores. There was no effect on service use or charges, perhaps due to inadequate sample size and lack of targeted drug groups analysis. The authors conclude that clinical pharmacists' consultations can improve geriatric patients' drug regimens and compliance. Findings further suggest the need for replication among large cohorts of patients at high risk, due to the use of medications most likely to have a potential for serious outcomes and to be vulnerable to physician prescribing error.
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