Patient compliance with medication prescriptions in the period immediately following hospital discharge should be of concern to all hospital personnel responsible for the appropriate use of medications, notably Pharmacy and Therapeutics and Quality Assurance Committees. We reviewed the medical records of patients over age 65 discharged from one acute-care hospital. Two days after discharge, we contacted subjects by phone and determined which medications they were taking and at what frequency. We compared discharge orders for medication use with actual use, as determined by self-reports. Of the 44 patients for whom we had complete data, 64% used at least one medication that was not ordered by the physician at discharge, and 73% failed to use at least one medication according to the way it was ordered. Of all drugs ordered at discharge, 32% were not taken at all. Hospital personnel should evaluate their discharge procedures and test techniques to improve compliance in discharged elderly patients.