Patient's discharge from hospital is associated with iatrogenic events for 12 to 17% of
patients. This risk may be linked with discontinuity of care between hospital physicians and
Primary Care Physician (PCP). The investigators aim to assess in this study the impact of
medication reconciliation at discharge associated with a patient's counseling session, both
provided by a pharmacist, on patient's care after discharge. To demonstrate the interest of
medication reconciliation at discharge we expect a reduction by 15% of the number of
prescription changes not maintained by the PCP after discharge.