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Tijdschrift voor Psychiatrie 58 (2016) 4, 262 - 271

New research

Medication review in the mental health care service: experiences on long-stay units

P.E. Graveland, M.M. Beex-Oosterhuis, A. Gosker-Venis, R.J. van Marum, A.R. van Gool

background Medication review is a recurrent, structured and critical evaluation of pharmacotherapy by patient, physician and pharmacist. The Dutch Health Care Inspectorate considers medication review to be a way of improving the quality and safety of drug treatment. However, little is known about the costs, effectiveness and feasibility of medication review in the practice of mental health care.
aim To obtain an impression of the costs and benefits of a first medication review in a clinical mental health care setting with chronic patients.
method In 2013, the mental health organisation Yulius enrolled 70 hospitalised chronic patients for a first medication review. A detailed record was kept of the prescribed medication, medication changes, and the time invested.
results More than half of the proposed changes in medication were eventually implemented; 20% of these changes were made during a planned evaluation after three months. The number of drugs prescribed decreased after medication review; the reduction applied more often to somatic medication than to psychotropic medication. Costs relating to medication reviews seemed to be at least in balance with the benefits.
conclusion In the group of patients with severe mental disorder, medication review seems to provide a good opportunity to assess the rationality of pharmacotherapy in a multidisciplinary approach. The time invested appears to be offset by the benefits of medication review.

keywords medication review, polypharmacy, severe mental illness