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The most frequent medical intervention performed by a doctor is the writing of a prescription. Because chronic illness increases with advancing age, older people are more likely to have conditions that require drug treatment. Advanced age, frailty, and increased use of drugs are all factors that contribute to a patient's risk of developing a drug related problem. As many as 28% of hospital admissions in the United States of older people are as a result of drug related problems, 1 up to 70% of which are attributed to adverse reactions to drugs. 1 Creating optimal drug regimens that meet the complex needs of elderly people requires thought and careful planning.

Inappropriate prescribing is expensive. In a recent study the costs of preventable adverse drug events—namely, injury resulting from a drug related medical intervention—occurring during a stay in hospital were estimated to be $2.8 m (£ 1.75) annually in two large …