Background Older patients are vulnerable to experiencing drug related problems (DRPs), which may result in emergency department (ED) visits. However, it is not standard practice to conduct medications reviews during ED visit. The aim of this study was to assess the number of DRPs in older patients living with frailty at the ED, identified through pharmacist-led medication reviews within a geriatric care team, and to determine the acceptance rate of pharmacists’ recommendations among hospital physicians and general practitioners or elderly care specialists. Methods A retrospective observational study was performed in patients ≥ 70 years living with frailty at the ED at Tergooi Medical Center. Pharmacist-led medication reviews were conducted to identify and classify DRPs as part of a larger geriatric assessment. The acceptance rate of given recommendations was determined during follow-up. Results A total of 356 ED visits were included. The mean (standard deviation, SD) age of patients was 83 (6.8) years. About 76% of patients had at least one DRP. In total, 548 DRPs were identified with a mean of 1.5 DRP (SD 1.3) per patient. The acceptance rate of medication recommendations in admitted patients was 55%, and 32% among general practitioners/elderly care specialists in discharged patients. Conclusions Pharmacist-led medication reviews as part of a geriatric care team identified DRPs in 76% of older patients living with frailty at the ED. The acceptance rate was substantially higher in admitted patients compared to discharged patients.

Background Older patients are at risk of drug related problems (DRPs), potentially leading to emergency department (ED) visits. Identifying DRPs with medication reviews is typically evaluated in restrictive clinical studies and not in a ‘real-world’ setting with organizational challenges and time-pressure. This study aims to assess the number of DRPs at the ED in older patients living with frailty, and to determine the acceptance rate of medication recommendations among physicians and the general practitioner. Additionally, practical recommendations are provided for implementing a medication review program. Methods A retrospective observational study was performed in patients ≥ 70 years living with frailty who visited the ED at Tergooi Medical Center. Medication reviews were conducted to identify and classify DRPs as part of a larger geriatric assessment. Also, the acceptance rate of given recommendations was assessed. Results A total of 356 ED visits were included. The mean age of patients was 83 years. About 76% of patients had at least one DRP. In total, 548 DRPs were identified with a mean of 1.5 DRP per patient. The acceptance rate of medication recommendations in admitted patients was 55%, and 32% among general practitioners/elderly care specialists in discharged patients. Conclusions Our results show that medication reviews lead to better assessment of DRPs at the ED. The acceptance rate was substantially higher in admitted patients compared to discharged patients. Results of our study reflect the real-life setting of conducting medication reviews at the ED for older patients living with frailty.