Objectives To establish the feasibility and the specific tasks of a multidisciplinary team approach for medical review in four nursing homes for the elderly in Italy.

Methods Prospective study conducted between November 2012 and September 2013. Review of therapies was performed by seven clinical pharmacists and four nurses using composite criteria for drug discrepancy evaluation with subsequent submission to 31 physicians.

Results The rate of prevalence of drug discrepancies recorded for 2556 medications reviewed in 333 patients was 34.1% (871/2556). Of these, only 35.5% (309/871) were accepted by clinicians. The highest clinician acceptance rates were observed for drug substitutions (91.3%, 211/231) and dosing regimen modifications (96.4%, 53/55). A significant decrease in the mean number of medications prescribed per patient (from 7.7±2.8 to 7.3±2.7, p<0.05) was observed.

Conclusions Interventions aimed at improving interactions between pharmacists and physicians and awareness among physicians of major pharmacological interactions should be encouraged.