An evaluation of drug therapy is part of comprehensive geriatric assessment. Medications were systematically reviewed in 35 hospitalized patients within the first 3 days after admission and the day before discharge by external rating. The results and the assessment findings were provided to the patients' physicians. The assessment was accomplished by investigations on patient compliance and the handling of different medication containers. One-third of the total pharmacotherapeutic findings in 23 patients was related to new indications for drug treatment, the remaining 27 findings considered unclear indications and adaptations of dosing/application. In total, the number of prescriptions decreased. Fifty-six % of the findings were followed by therapeutic consequences. There was evidence of intentional and unintentional non-compliance in nearly three-quarters of the patients. Problems with handling/opening of medication containers differed with the type of the container's closure. Additional medication counseling was recommended in 14 patients. It is concluded that systematic medication review together with comprehensive geriatric assessment enhance more critical drug prescribing, and reveal patient non-compliance and problems with medication handling.