The rationale of the CMM intervention is based on the statements of the International Pharmaceutical Federation which describes a model of Collaborative Pharmacy Practice with advancing models that facilitate interprofessional collaboration and greater pharmacist accountability.69 The intervention will consist of a five-step CMM practice by reviewing medication appropriateness, including PIM and FRID. Results of a focused review will be used to identify FRID. Screening tools of the MAI, PRISCUS list and Fit fOR The Aged (FORTA) list will be used to assess medication use. The MAI represents a reliable and valid measure of medication appropriateness and appears to be a useful tool for research studies, quality improvement studies and patient care programmes.70 71 (link) The FORTA list was recently updated in 2021 and comprises four categories classified by an expert Delphi panel.72 (link) The PRISCUS list was developed for the German market and includes inappropriate substances comprising antidepressants, antihypertensives and hypnotics/sedatives which are linked to increased risk of falling.73–75 (link) Identified drug-related problems, recommendations and acceptance will be documented by the Pharmaceutical Care Network Europe V.9.1 classification system.76 Final clinical decisions on medication optimisation will be based on clinical expertise, patients’ perceptions and ultimately by the geriatrician as the approving authority. CMM interventions and a digitally created medication plan will be included in the patients’ letters of discharge (process results from T2 and T3). The medication plan includes medication (name, dose, frequency) and start/stop dates. Orthopaedists/Traumatologists prepare the information (digital and printed) at T4 to enable availability for patients and physicians at the inpatient and outpatient care sector. The five-step CMM process consists of recording, reviewing, discussion, communication and documentation. Core elements of a Medication Therapy Management Service of the American Pharmacists Association and National Association of Chain Drug Stores Foundation inspired the design of the process which underwent setting-specific adaption.77 (link) The five interventional steps are shown in figure 3.