Table 1

Examples of temporary medications continued as legacy prescriptions

SituationRisk of harmExample
Medications used during infections for symptom reliefPotential misuse of the medication for a similar symptom caused by another condition instead of seeking care from a healthcare professionalContinued use of salbutamol inhaler after acute pulmonary infection
Short term PPI therapy turns into chronic therapyLong-term side effects of PPIs include impaired B12 absorption, hypomagnesaemia, increased risk of Clostridium difficile infection, community-acquired pneumonia41Chronic PPI use for indications such as GERD, mild-moderate oesophagitis, PUD caused by NSAID or Helicobacter pylori41
Opioids during perioperative careExposure to opioid toxicities, risk of developing dependence20Continued postsurgery for non-cancer pain in an opioid-naïve patient
BenzodiazepinesAssociated with falls, memory disorders, dementia, functional impairment, daytime sedation, motor vehicle accidents42Used for depressive episodes or grief
AntipsychoticsIncreased risk of weight gain, dry mouth, dizziness, EPS, UTIs, cardiovascular adverse events43Prescribed for insomnia or anxiety after moving into a new environment
AntiepilepticsSignificant drug–drug interactions (some are strong enzyme inducers); long-term side effects include bone density reduction, hyperlipidaemia, folate deficiency44Patient 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.