title: Medication Discrepancies at Outpatient Departments for Mood and Anxiety Disorders in the Netherlands: Risks and Clinical Relevance.
abstract: OBJECTIVE
  To identify discrepancies between actual drug use by outpatients with mood and anxiety disorders and medication overviews from health care providers as well as to investigate the clinical relevance of those discrepancies.
  
  
  METHODS
  A cross-sectional study in adults visiting 1 of 4 participating outpatient departments for mood and anxiety disorders was conducted between March and November 2014. DSM-5 criteria were used to assign the psychiatric diagnosis. The primary outcome was the number of discrepancies between the actual medication use, as determined by medication reconciliation with the patient, and the medication overview from the outpatient department, general practitioner, and community pharmacy. Our secondary outcome was the clinical relevance of discrepancies, as assessed by an expert panel that reviewed all discrepancies for their potential to cause patient harm.
  
  
  RESULTS
  Of 367 patients included, 94.8% had at least 1 discrepancy in the medication overview from the outpatient department. A mean of 3.9 discrepancies existed per patient. Most discrepancies (74.5%) related to omitted drugs (drugs taken regularly by patients but absent from the medication overview). Of all discrepancies at the outpatient departments, 22.7% had the potential to cause moderate to severe discomfort or clinical deterioration, affecting 49.3% of the patients. Both total number and number of clinically relevant discrepancies were lower in medication overviews from general practitioners and pharmacies.
  
  
  CONCLUSIONS
  Patients from outpatient departments for mood and anxiety disorders may be at substantial risk for medication discrepancies that are often clinically relevant. Medication reconciliation at mental health care outpatient departments is in need of improvement.
authors.affiliation: Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands.|Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|Unit of Pharmacotherapy and Pharmaceutical Care, Department of Pharmacy, University of Groningen, Groningen, the Netherlands.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Simoons
authors.affiliation: Department of Clinical Pharmacy, Wilhelmina Hospital Assen, PO Box 30001, 9400 RA Assen, the Netherlands. hans.mulder@wza.nl.|Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Mulder
authors.affiliation: Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands.
authors.forename: Arne J
authors.initials: AJ
authors.lastname: Risselada
authors.affiliation: Department of Psychiatry, Wilhelmina Hospital Assen, Assen, the Netherlands.
authors.forename: Frederik W
authors.initials: FW
authors.lastname: Wilmink
authors.affiliation: Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Schoevers
authors.affiliation: Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Henricus G
authors.initials: HG
authors.lastname: Ruhé
authors.affiliation: Unit of Pharmacotherapy and Pharmaceutical Care, Department of Pharmacy, University of Groningen, Groningen, the Netherlands.|Department of Clinical Pharmacy and Clinical Pharmacology, Medical Center Leeuwarden, Leeuwarden, the Netherlands.
authors.forename: Eric N
authors.initials: EN
authors.lastname: van Roon
mesh_terms: D000328:Adult; D014151:Anti-Anxiety Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy*; D009426:Netherlands; D010044:Outpatient Clinics, Hospital; D010348:Patient Care Team; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents