These high-risk periods for med errors, adverse drug events, and communication breakdowns can lead to hospital readmissions or worse health outcomes. Pharmacists help mitigate these risks by performing comprehensive medication reconciliation, assess medication appropriateness, and optimize therapy based on clinical status, and ensure continuity of care. We collaborate closely with physicians, nurses, and case managers to develop coordinated care plans and ensure that prescriptions are filled, follow-up appointments are scheduled, and that there is clear communication across care settings.

CMRs are especially important for geriatric patients due to their increased vulnerability to medication-related problems including adverse drug events, drug-drug interactions, medication non-adherence, and inappropriate prescribing. Our pharmacists not only improve medication safety and effectiveness for geriatric patients, but also enhance their quality of life, functional status, and independence—critical outcomes for this population.

Clinical pharmacists improve patient medication adherence by educating patients about side effects and indications, simplifying regimens by combining tablets or deprescribing, addressing barriers such as cognitive impairment or financial burden, and provide follow-up and support for adherence and therapeutic effects.

Reducing polypharmacy in geriatric patients is critically important due to the significant risks it poses to their health and well-being. Polypharmacy can lead to numerous complications in older adults, who are more sensitive to drug effects and often have altered metabolism and organ function. Pharmacists, in collaboration with prescribers, play a vital role in deprescribing—systematically reviewing and discontinuing unnecessary or potentially harmful medications—ensuring that every drug has a clear, evidence-based indication and aligns with the patient’s current health goals and life expectancy.

By guiding formulary-based medication selection and promoting cost-effective treatment options, our pharmacists help remove financial barriers, improve medication adherence, and ultimately contribute to better patient outcomes and more efficient use of healthcare resources. Our pharmacists utilize copay assistance programs for high-cost medications as well as alternative strategies like 90-day supplies or using mail-order pharmacies for long-term medications, which can reduce out-of-pocket costs.