title: Discontinuities in drug use upon hospital discharge.
abstract: OBJECTIVE
  To investigate the nature and frequency of changes in drug treatment upon discharge from hospital.
  
  
  METHODS
  All drugs of discharged patients, dispensed by an outpatient pharmacy were compared with the latest clinical medication and discontinuities were classified.
  
  
  RESULTS
  Of all prescriptions dispensed by the outpatient pharmacy, 40% had some discontinuity; most frequent were product substitution (27%) and new prescriptions, starting at the moment of discharge (11%).
  
  
  CONCLUSIONS
  There is a gap in the conformity between drugs used in the hospital and the drugs dispensed by the outpatient pharmacy at the moment of discharge.
authors.affiliation: General Hospital Hilversum, Department of Clinical Pharmacy, 1201 DA Hilversum, The Netherlands. rstuffken@zhh.nl
authors.forename: Rutger
authors.initials: R
authors.lastname: Stuffken
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D010607:Pharmacy Service, Hospital / Q000379:methods* / Q000706:statistics & numerical data