The Effect of Systematic Medication Review in Elderly Patients Admitted to an Orthopedic Department.

Elderly patients have a higher risk of experiencing adverse drug events due to an age related increase in morbidity and medication use. Inappropriate or wrong medication use among elderly patients acutely admitted to hospitals is assumed to result in earlier contact to general practitioner, emergency departments and re-admissions if not corrected during hospital admission. It is therefore our hypothesis that a systematic medication review conducted by pharmacists and physicians specialized in pharmacology will increase time to first unscheduled physician contact (general practitioner, emergency departments, ambulatory care and re-admissions) after discharge from hospital from an average of 21days to 25 days. Further, the following secondary outcome parameters will be measured at discharge and within 3-month follow-up:

• length of in-hospital stay
• number of contacts to general practitioner 30 days after discharge, that resulted in medication changes
• number of re-admissions at 3-month
• number of death at 3-month
• number of contact to primary health care at 3-month
• patients self-experienced quality of health(EQ-5D) 3-month