PhD defence E.B. (Elien) Uitvlugt

The research in this thesis shows that 16% of the unplanned readmissions within 30 days after discharge are medication-related and of these, 40% are potentially preventable. Causes of potentially preventable readmissions are prescribing errors, non-adherence and transition errors. Transition errors were among others caused by a lack of accurate communication of up to 50% of prescribed medication to the next healthcare provider. Also, patients had difficulty in implementing medication changes of hospital care into their daily lives after hospital discharge. Collaboration between hospitals and care providers in community care is important to improve continuity of care. To reduce medication related harm after discharge, a care program was studied in a general teaching hospital, a university hospital and 49 community pharmacies. This program consisted of improved medication information to the patient, a medication-related discharge letter for the community pharmacist, a home visit after discharge and a medication review performed by the hospital pharmacist and the community pharmacist. No effect of this program was found on the occurrence of ADEs after discharge compared to usual care. If only those patients who have received a complete program were considered, an effect in the general teaching hospital was found. No effect was seen in the university hospital either. Differences in program implementation and patient characteristics may explain this. In conclusion, medication-related readmissions frequently occur despite several interventions. The findings of this thesis provide insight into the frequency and types of harm after discharge and could help with the implementation of pharmaceutical care for patients discharged from hospital to reduce medication-related harm.

Due to corona, the PhD defences do not take place publicly in the usual way in the Senate Hall or in the Professor Andries Querido Room. The candidates will defend their dissertation either in a small group or online.