1: J Am Geriatr Soc. 2007 May;55(5):658-65. Effect of a collaborative approach on the quality of prescribing for geriatric inpatients: a randomized, controlled trial. Spinewine A, Swine C, Dhillon S, Lambert P, Nachega JB, Wilmotte L, Tulkens PM. Center for Clinical Pharmacy, School of Pharmacy, Université Catholique de Louvain, Brussels, Belgium. anne.spinewine@facm.ucl.ac.be OBJECTIVES: To evaluate the effect of pharmaceutical care provided in addition to acute Geriatric Evaluation and Management (GEM) care on the appropriateness of prescribing. DESIGN: Randomized, controlled trial, with the patient as unit of randomization. SETTING: Acute GEM unit. PARTICIPANTS: Two hundred three patients aged 70 and older. INTERVENTION: Pharmaceutical care provided from admission to discharge by a specialist clinical pharmacist who had direct contacts with the GEM team and patients. MEASUREMENTS: Appropriateness of prescribing on admission, at discharge, and 3 months after discharge, using the Medication Appropriateness Index (MAI), Beers criteria, and Assessing Care of Vulnerable Elders (ACOVE) underuse criteria and mortality, readmission, and emergency visits up to 12 months after discharge. RESULTS: Intervention patients were significantly more likely than control patients to have an improvement in the MAI and in the ACOVE underuse criteria from admission to discharge (odds ratio (OR)=9.1, 95% confidence interval (CI)=4.2-21.6 and OR=6.1, 95% CI=2.2-17.0, respectively). The control and intervention groups had comparable improvements in the Beers criteria. CONCLUSION: Pharmaceutical care provided in the context of acute GEM care improved the appropriate use of medicines during the hospital stay and after discharge. This is an important finding, because only limited data exist on the effect of various strategies to improve medication use in elderly inpatients. The present approach has the potential to minimize risk and improve patient outcomes. Publication Types: Randomized Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't PMID: 17493184 [PubMed - indexed for MEDLINE] Related Links Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. [Am J Geriatr Pharmacother. 2004] PMID:15903284 Effect of a geriatric consultation team on functional status of elderly hospitalized patients. A randomized, controlled clinical trial. [Ann Intern Med. 1989] PMID:2642284 An outreach geriatric medication advisory service in residential aged care: a randomised controlled trial of case conferencing. [Age Ageing. 2004] PMID:15385274 A randomized, controlled trial of comprehensive geriatric assessment and multidisciplinary intervention after discharge of elderly from the emergency department--the DEED II study. [J Am Geriatr Soc. 2004] PMID:15341540 A controlled trial of inpatient and outpatient geriatric evaluation and management. [N Engl J Med. 2002] PMID:11907291