Table 2

Twelve prescription-only medications discontinued during hospitalisation but still used by patient: potential implications

Sex	Age, years	Drug	Indication	Reason for discontinuation	Implication of use
COPD, chronic obstructive pulmonary disease.
Male	62	Codeine	Analgesic	Acetaminophen prescribed instead	Risk of constipation. Patient with resected colon
Female	91	Trandolapril	Not stated	No reason stated	Risk of harmful effects of an unnecessary treatment
		Bendroflumethiazide	Not stated	No reason stated	Risk of harmful effects of an unnecessary treatment
		Tramadol	Analgesic	No reason stated	Risk of harmful effects of an unnecessary treatment
Female	61	Diazepam	Muscular relaxant, analgesic	No reason stated	Risk of misuse
Female	61	Ibuprofen	Analgesic	No reason stated	Risk of harmful effects of an unnecessary treatment
Female	77	Terbutaline	COPD	Ipratropium/feneterol combination treatment prescribed instead	Limited
Female	77	Salbutamol	COPD		Unnecessary double treatment
Female	66	Salmeterol	COPD	Salmeterol/fluticason combination inhalation prescribed instead	Limited
Female	75	Digoxin	Atrial fibrillation	Sinusrhytm	Risk of harmful effects of an unnecessary treatment
Female	88	Metformin	Diabetes	Stable blood sugars	Risk of hypoglycaemia
Female	88	Spironolactone	Diuretic	Renal insufficiency	Risk of hyperkalaemia