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<h3>Background and Importance</h3> Frail institutionalised older adults frequently receive 10 or more medications, exposing them to clinically relevant drug–drug interactions, dosing errors and unnecessary treatments. Published evidence shows that structured medication review reduces inappropriate prescribing, but real-world practice often lacks standardised data collection and consistent multidisciplinary evaluation. A practical model capable of identifying specific medication-related problems and enabling rapid corrective action is needed to improve safety and optimise therapy in this population. <h3>Aim and Objectives</h3> The aim was to implement and assess a digital, stepwise medication review process in long-term care residents. Objectives were: (1) detect concrete prescribing problems; (2) apply targeted interventions such as deprescribing, dose correction or therapy substitution; (3) standardise the review process across clinicians; (4) evaluate early changes in medication appropriateness and regimen complexity. <h3>Material and Methods</h3> A four-step operational workflow was used. Data collection: A structured digital form captured comorbidities, functional and cognitive status, lab results, complete medication list, therapeutic indication for each drug, and previous ADRs. Medication analysis: Each drug was assessed for indication, dose, frequency, interactions, contraindications and duplication using Summary of Product Characteristics, three interaction checkers, BEERS, START/STOPP and Anticholinergic Burden score. For every issue, a specific action (eg, reduce dose, discontinue, replace, modify timing, initiate monitoring) was documented. Multidisciplinary teleconsultation: Pharmacist, physician and geriatrician reviewed each proposal and approved final therapeutic changes. Follow–up: At 3, 6 and 12 months, Medication Appropriateness Index (MAI), adherence indicators, tolerability data and new interactions were reassessed. <h3>Results</h3> Nine residents completed the full review. Median medication count was 11. All residents had at least one inappropriate prescription. Issues identified included lack of indication (38%), dosing errors (45%), clinically relevant interactions (52%) and duplication (31%). All residents received concrete interventions: deprescribing of unnecessary drugs, dose adjustments, therapy substitutions or scheduling changes. No unexpected adverse events occurred during early follow-up. Initial reassessment shows reduced regimen complexity and improved MAI scores. <h3>Conclusion and Relevance</h3> The workflow proved directly applicable in routine practice, producing measurable corrections to therapy and structured deprescribing. Early data show improved medication appropriateness and reduced pharmacological burden. The model is operational, reproducible and suitable for wider use in long-term care settings. <h3>Conflict of Interest</h3> No conflict of interest