Bastiaan Sallevelt

354 CHAPTER 4.3 clinical indication, the use of double medication, or the use of a drug beyond the recommended duration. Underuse was defined as the lack of use of an indicated drug according to evidence-based clinical guidelines, adherence issues, or the discontinuation of a drug before the recommended prescription period was completed (e.g. antibiotics). Misuse included inappropriate dosing, inadequate therapy monitoring, the presence of clinically relevant drug-disease, or drug-drug interactions of indicated drugs [14]. Figure 1 presents a graphical illustration of the relationship between the in-hospital medication review at index hospitalisation and the DRA adjudication process at readmission. Figure 1. Graphical illustration of the relationship between the in-hospital medication review and the adjudication process of drug-related admissions. DRA = Drug-related hospital admission; CDSS = Clinical decision support system; STOPP/ START v2 = Screening Tool of Older Person’s Prescriptions / Screening Tool to Alert doctors to Right Treatment, version 2; GP = General practitioner.

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