Please select the eligibility criteria that correspond to the clinical trial below.
Title: Clinical and Economical Assessment of an Intervention to Reduce Potentially Inappropriate Medication in Polymedicated Elderly Patients
Brief Summary: Objective: To evaluate the clinical and economic impact of the application of an algorithm to improve the adequacy and safety of pharmacotherapy in elderly polymedicated (receiving 8 or more medications), not institutionalized.

Design: randomized, open, multicenter and two branches of parallel intervention clinical trial.

Intervention Study: primary care pharmacist apply the GP-GP algorithm to each drug with the support of STOPP criteria, Beers and / or recommendations CatSalut. The pharmacist submit to doctor his findings and reach a consensus and decide which recommendations will be presented to patient. Control intervention: usual procedure.

Main outcome measures: a) Discontinued medications, changed or changing doses, b) GP consultations, hospital emergency department and hospital admissions for acute illness, c) pharmaceutical expenditure, d) restart medication e) complications underlying diseases. Follow-up control at 1 month (security) and at 3, 6 and 12 months.


Options:
A: Inclusion Criteria:

* Aged ≥70 years
* Admitted to the geriatric internal medicine ward in the University Hospital of North Norway (UNN) Tromsø or the general internal medicine ward in UNN Harstad.
* Willing to provide written informed consent during hospital stay (patient or next of kin)

Exclusion Criteria:

* Unable to communicate in Norwegian (patient or next of kind)
* Terminally ill, e.g cancer in end-life stage
* Control group patients where the physician request an assessment from a pharmacist
* Time from admittance to the ward to inclusion is more than 72 hours
* Occupying a bed in the study wards but under the care of physicians from a non-study ward.
* Planned discharged on the inclusion day
B: Inclusion Criteria:

* Age greater than or equal to 65
* Resident in EHPAD
* presenting a high iatrogenic drug risk (Trivalle score between 6-10).
* Ability to provide free, informed and express consent (patient and / or trusted person)
* Affiliated to a social security scheme

Exclusion Criteria:

* Patient with a life expectancy \<3 months
* Patient under 65 years
* Trivale score \<6
* Vulnerable persons within the meaning of French law (adults under guardianship or trusteeship, persons deprived of their liberty)
* Participation in another research protocol in progress
* Patient who has had a medication review (or medication review) known in the last 6 months.
* Patient with severe dementia (MMSE \<18)
C: Inclusion Criteria:

Patients are included in the study if they have any of the following:

* Have had at least 1 unplanned hospital admission or 2 or more accident and emergency department (A\&E) attendances in the previous 12 months.
* Prescribed ≥ 6 regular oral/systemic, long term medicines.
* Has ≥ 2 long-term chronic conditions.

Exclusion Criteria:

* Patient is residing in a nursing home or a care home.
* Patient is considered unable to give written informed consent e.g. Alzheimer's disease.
* Palliative care patients.
* Patient has had ≥ 4 unplanned admissions to hospital in the previous 6 months.
* Patient is participating in another intervention research project within the practice.
D: Inclusion Criteria:

* 70 years or more
* Currently receiving eight or more drugs, except ointments and administered via topical nonprescription
* Give their informed written consent to participate in the study.

Exclusion Criteria:

* Estimated life expectancy less than 6 months.
* Active cancer
* Participation in any other clinical trial or program for evaluation of medication in the elderly.
* Institutionalized in nursing homes.
* Surgical intervention scheduled for the next 6 months

Answer: D