From 12 to 14 June 2014, an international multidisciplinary team of experts assembled in Ghent, Belgium, for a European Science Foundation (ESF) exploratory workshop, focusing on the quality of pharmacotherapy in old age. Pharmacotherapy in old age needs to be appraised in the context of ageing, taking into account the importance of multimorbidity, disability, frailty, and changing care goals. Several characteristics of ageing affect prescribing and influence appropriate pharmacotherapy in old age. In recent years, several instruments have been developed that may be helpful in guiding clinicians when they assess prescribing. These are often classified into implicit or explicit for the assessment of pharmacotherapy. Implicit measures are judgment based, are patient specific, and consider the entire medication regimen. An example is a medication chart review, using the medication appropriateness index (MAI). Implicit measures are often question-based and time-consuming and require a high level of skill from the assessor. Explicit measures are based on predefined lists with a varying number of explicit drug-oriented and/or disease oriented criteria (e.g. Beers’ lists, STOPP-START, PRISCUS and NORGEP. These explicit criteria have mainly been developed from published reviews, expert opinions, and consensus techniques . Explicit criteria are not question based, but are rather formulated as an algorithm used to check for prerequisites to identify potentially inappropriate medications (PIMs). These PIMs can be defined as ‘medications that have no clear evidence-based indication, carry a high risk of adverse side effects or are not cost-effective’. Because explicit criteria are collections of a varying number of PIMs, they are defined in this paper as lists of PIMs. Within these lists, the nature of the PIMs varies considerably, from PIMs including only a particular drug name or a drug class to complex descriptions including diagnostic and clinical information. Lists of PIMs have been used in assessing pharmacotherapy in individual patients and the quality of care in healthcare settings. Adaptability to national drug markets, suitability for automated electronic assessment, and access to high quality clinical information in electronic health records are the main barriers to the more generalized use of these tools in daily practice. Therefore, the aim of the ESF exploratory workshop was to define the requirements for routine automated electronic evaluation of the quality of pharmacotherapy, through secondary use of medication records and clinical data.