NCT03156348.

Methods	RCT (3 groups)
Participants	Inclusion: patients 60 years or older attended by the staff of internists of the internal medicine service of the Clinical Hospital of the University of Chile for acute condition or decompensation of chronic pathology; with estimated survival > 6 months; on pharmacological therapy; having a contact person or responsible caregiver willing to comply with the scheduled care plan; and having a contact telephone number Exclusion: cognitive impairment and no caregiver, any other condition that in the judgement of the research team affects the quality of the collection of information
Interventions	Intervention: during hospitalisation and at discharge, a clinical pharmacist (CP) will monitor daily pharmacological safety and efficacy of the medication to assess and make appropriate recommendations. CP will explain the reasons for use of each of the drugs. At 30 days post discharge, CP will review the updated clinical record of the patient and will conduct a home visit to enhance and ask about adherence, self‐medication, medication use at that time, and possible results of laboratory tests performed and to clarify doubts regarding the use of current medications. The same activities will be conducted at 60 days by telephonic way, to reinforce the recommendations Parallel control: usual care by team with training on pharmacogeriatrics Historical control group: usual care (no training)
Outcomes	Adherence measured with Morisky and Green scale, adverse drug events, hospitalisations, prevalence of self‐medication (taking a drug without medical indications)
Notes	NCT03156348 Start date: May 2015. Estimated completion: December 2017 Investigators contacted for more information (email: comiteetica@hcuch.cl) ‐ no response Note: need to determine mean/median number of medications to confirm eligibility