Please select the eligibility criteria that correspond to the clinical trial below.
Title: GP Practice Based Pharmacist Input to Medicines Optimisation
Brief Summary: The study is a United Kingdom (UK) based multi-centre study which will evaluate the impact of a medication optimisation intervention (delivered in GP practices by pharmacists to patients at risk of medication related problems), on healthcare resource utilisation and patient outcomes. Pharmacists in 4 areas across the UK (3 in England and 1 in Northern Ireland) will engage with patients, thought to be at a higher risk of medication related problems, within their GP practice in order to help identify areas for improvement


Options:
A: Inclusion Criteria

* Being a regular patient of participating GP
* Age: 65 years of age or older
* Multimorbidity: 3 or more coexistent chronic conditions defined by 3 distinct International Classification in Primary Care -2 (ICPC-2) codes defined as chronic (O'Halloran et al., 2004) with an estimated duration of 6 months or more, or based on a clinical decision supported by Pharmacost Groups (PCG) for chronic conditions in an algorithm from FIRE
* Polypharmacy: Use of five or more different regular drugs (defined as authorized medications with registration numbers) for more than 30 days before signing the informed consent form

Exclusion Criteria

* Inability to provide informed consent from a patient or to obtain informed consent from a proxy for patients with cognitive impairment
* If the patient is already participating in the a different interventional study
B: 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.
C: Nursing Home Wards:

Inclusion criteria:

* Long stay ward
* Capability and commitment to perform a multidisciplinary multistep medication review.

Exclusion criteria:

* Short stay, revalidation or observation wards
* Specialized ward where patients with an atypical etiology are cared for.
* Elderly care physicians who have recently received or who are to receive recertification at short notice with regard to systematic medication review methodology.
* Participation in other studies aimed at improving the quality of drug prescription (in the past 12 months).

Nursing Home Residents:

Inclusion criteria:

* A life expectancy of \>4 weeks as judged by the treating elderly care physician.
* IC provided by patients themselves or provided by a legal representative for incapacitated patients.

Exclusion criteria:

* Refusal of treatment with medicines.
* Having received a multidisciplinary systematic medication review in the past 6 months.
* Being terminally ill and having a life expectancy ≤ 4 weeks as judged by the treating elderly care physician.
* Other reasons at the discretion of the elderly care physician / nursing staff
D: Inclusion Criteria:

* at least 60 years old of both sexes
* at least three chronic diseases affecting two or more organ systems, which require pharmaceutical treatment
* at least five long-term prescriptions with systemic effects
* health care provided by GP (at least one contact in most recent quarter)
* patient is legally competent to sign any documents
* ability to understand and participate in trial of own free will, to fill out questionnaires and participate in telephone interviews
* written informed consent to participate in trial

Exclusion Criteria:

* diseases cause life expectancy of less than 12 months
* abuse of alcohol or illegal drugs and visible clinical signs or symptoms thereof
* cognitive impairment that prevents trial participation (MMSE \< 26)
* emotional stress that prevents trial participation
* participation in a clinical trial within the last 30 days

Answer: B