OBJECTIVES: The Healthy Families Succeed Pilot used nurse-pharmacists teams to test the effects of a home visitation, family-centered, clinical prevention intervention on health, service utilization and self-sufficiency. 1) Describe the types of medication-related interventions of the teams; 2) determine factors associated with polypharmacy, and 3) determine the impact the teams had on adherence. METHODS: Design: randomized, two group comparison. Selection: Inclusion criteria: use of multiple state programs and polypharmacy (>10 unique drugs/year). Exclusion: age >65, incarceration. Process: Two nurse-pharmacist teams participated. Nurses made home visits throughout the pilot study. Pharmacists reviewed records, made home visits and served as consultants to the nurses and families. Analysis: Interviews with the teams were used to collect data related to the interventions and families' patterns of medication use. Regression analysis was performed on integrated health and social claims data to identify factors related to polypharmacy and adherence to medication regimens (measured by medication possession ratios). RESULTS: Thirty-five families were assigned to the study group and 33 in the control group. The teams found medication problems in 97% of the intervention households. Problems included: adherence (44%); lack of disease control (37%); administration/storage problems (30%); ADR/interactions (25%); and no indication for medication use (28%). Factors associated with poly-pharmacy included: increasing age, female gender, number of providers, number of ER visits, presence of a mental health or respiratory diagnosis, number of diagnoses, and county of residence. Medication fills/month and average MPR increased, while the number of unique drugs declined in the study group, relative to the control group. CONCLUSION: Most medication problems were related to lack of understanding. Poor adherence was commonly associated with lack of timely access to understandable information. Families used the education and support provided by the teams to improve adherence. Polypharmacy is an effective measure for identifying families in need of clinical prevention.