Examples of temporary medications continued as legacy prescriptions
Situation | Risk of harm | Example |
Medications used during infections for symptom relief | Potential misuse of the medication for a similar symptom caused by another condition instead of seeking care from a healthcare professional | Continued use of salbutamol inhaler after acute pulmonary infection |
Short term PPI therapy turns into chronic therapy | Long-term side effects of PPIs include impaired B12 absorption, hypomagnesaemia, increased risk of Clostridium difficile infection, community-acquired pneumonia41 | Chronic PPI use for indications such as GERD, mild-moderate oesophagitis, PUD caused by NSAID or Helicobacter pylori41 |
Opioids during perioperative care | Exposure to opioid toxicities, risk of developing dependence20 | Continued postsurgery for non-cancer pain in an opioid-naïve patient |
Benzodiazepines | Associated with falls, memory disorders, dementia, functional impairment, daytime sedation, motor vehicle accidents42 | Used for depressive episodes or grief |
Antipsychotics | Increased risk of weight gain, dry mouth, dizziness, EPS, UTIs, cardiovascular adverse events43 | Prescribed for insomnia or anxiety after moving into a new environment |
Antiepileptics | Significant drug–drug interactions (some are strong enzyme inducers); long-term side effects include bone density reduction, hyperlipidaemia, folate deficiency44 | Patient with childhood-onset epilepsy who is seizure free, but chronic antiepileptic use is not reassessed or discussed45 |
EPS, Extrapyramidal symptoms; GERD, Gastroesophageal reflux disease; NSAIDS, non-steroidal anti-inflammatory drug; PPI, proton-pump inhibitor; PUD, Peptic Ulcer disease; UTIs, Urinary Tract infections.