OBJECTIVES: The aim of this study was to assess the potential benefit of pharmacist home care visit for elderly patients who have at least one or more than one chronic diseases at long term care. METHODS: Using the claim database of Chi-Mei Medical Center from 2007 to 2008, patients aged 65 years and treated with over five medications were recruited. Pharmacists visited their home once a month to give them education on drug administration, drug interaction, duplicated drug use, adverse drug reaction etc and then followed up by telephone to see their condition after education. Pharmacists were created drug profile for each patient and recorded the items of education and discussed with their visiting physicians about their drug regimen in case there were inappropriated drug usage. RESULTS: At first visit, the average number of drugs prescribed to one patient was 5.89. There were 43.07% (28/65) and 27.69% (18/65) patients treated with poly-pharmacy and inappropriate drug use, respectively. The association of polypharmacy and inappropriate medication was significant.(P<0.001; 95% confidence interval: 82.56). The most common medication-related problems were the use of medication without proper indication (38.46%, 25/85), inappropriate administration route (34.85%, 22/65), poor compliance (55.38%, 36/65). The potential adverse drug reactions and drug interactions appeared in 8 patients and 12 patients, respectively. The outcome of pharmacist home care services include the reduction rate of outpatient visit from 1.38 times to 0.98 times every month; the decrease of items of drugs prescribed in one prescription was from 5.89 to 3.21; The average drug cost was reduced about NT 15 million per year( p<0.05). About 42% of patients satisfied with pharmacists’ home visit.CONCLUSIONS: The pharmacist home care service provides an assessment on many problems with drug administration not otherwise detected easily. These assessments can lead to potentially useful interventions that can improve medication regimens, compliance and reduce drug costs.