Objective: To investigate the nature and frequency of changes in drug treatment upon discharge from hospital.
Method: All drugs of discharged patients, dispensed by an outpatient pharmacy were compared with the latest clinical medication and discontinuities were classified.
Results: Of all prescriptions dispensed by the outpatient pharmacy, 40% had some discontinuity; most frequent were product substitution (27%) and new prescriptions, starting at the moment of discharge (11%).
Conclusion: There is a gap in the conformity between drugs used in the hospital and the drugs dispensed by the outpatient pharmacy at the moment of discharge.