Aim: To measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients by community pharmacists.Method: A randomised, controlled, longitudinal, clinical trial with repeated measures was performed over an 18‐month period, involving community pharmacies (5 intervention and 5 control) in Northern Ireland. Elderly, ambulatory patients (≥ 65 years), taking 4 or more prescribed medications were eligible for participation. Patients attending an intervention pharmacy received education on medical conditions, implementation of compliance strategies, rationalising of drug regimens and appropriate monitoring; patients attending control sites received normal services. A battery of clinical, humanistic and economic outcomes were assessed.Results: A significantly higher proportion of intervention patients were compliant at the end of the 18‐month study and experienced fewer problems with medication compared to control patients (P < 0.05). There was little impact on quality of life and health care utilisation.Conclusions: Pharmaceutical care provision to community‐dwelling patients resulted in an improvement in medication compliance and evidence of cost‐savings. Future pharmaceutical care studies may benefit from a more focussed selective approach to data collection and outcomes measurement.