Department of Clinical Pharmacy, Wilhelmina Hospital Assen, Assen, the Netherlands.
Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
J Clin Psychiatry. 2016 Nov;77(11):1511-1518. doi: 10.4088/JCP.15m10376.
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.
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.
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.
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.
识别心境和焦虑障碍门诊患者实际用药与医疗保健提供者药物综述之间的差异，并调查这些差异的临床相关性。
这是一项在 2014 年 3 月至 11 月期间在 4 个参与的心境和焦虑障碍门诊部门就诊的成年人中进行的横断面研究。使用 DSM-5 标准对精神科诊断进行分类。主要结局是通过与患者进行药物核对确定的实际用药与门诊、全科医生和社区药房药物综述之间的差异数量。我们的次要结局是通过专家小组评估差异的临床相关性来确定，该小组审查了所有差异，以评估其对患者造成伤害的可能性。
在 367 名纳入的患者中，94.8%的患者在门诊药物综述中至少存在 1 种差异。每位患者平均存在 3.9 种差异。大多数差异（74.5%）与遗漏药物有关（患者定期服用但不在药物综述中的药物）。在所有门诊差异中，22.7%有导致中度至重度不适或临床恶化的潜力，影响 49.3%的患者。全科医生和药店药物综述中的总差异数和临床相关差异数均较低。
心境和焦虑障碍门诊患者可能面临严重的药物差异风险，这些差异通常具有临床相关性。精神保健门诊部门的药物核对需要改进。
