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Prescribing of medication is the most common intervention experienced by older people in nursing homes. The quality and appropriateness of prescribing in this setting has often been criticized, with excessive use of certain types of medication (e.g., psychoactive drugs) that may result in adverse drug events for vulnerable residents. Research has indicated that adverse drug events in nursing home residents often arise as a result of selection of inappropriate drugs, inadequate monitoring of medication and inattention to communication, particularly between different health settings. Strategies to minimize adverse drug events should consider effective multidisciplinary working, with greater input from pharmacists, training in pharmacotherapy for older people, the development of systems that support prescribing, monitoring and care transitions, and careful consideration of the aims of drug therapy in this frail population.