Table 4 Omitted treatments that could be restarted

Cardiovascular system

Vitamin K antagonists or direct thrombin inhibitors or factor Xa inhibitors in the presence of chronic atrial fibrillation

2.10

1.64–2.55

Antiplatelet therapy (aspirin or clopidogrel or prasugrel or ticagrelor) with a documented history of coronary, cerebral or peripheral vascular disease

1.71

1.39–2.04

Antihypertensive therapy where systolic blood pressure consistently > 160 mmHg and/or diastolic blood pressure consistently > 90 mmHg; if systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg, if diabetic

2.24

1.89–2.59

Statin therapy with a documented history of coronary, cerebral or peripheral vascular disease, unless the patient’s status is end-of-life or age is > 85 years

1.90

1.59–2.22

Angiotensin Converting Enzyme (ACE) inhibitor with systolic heart failure and/or documented coronary artery disease

1.67

1.40–1.93

Beta-blocker with ischaemic heart disease

1.95

1.56–2.35

Appropriate beta-blocker (bisoprolol, nebivolol, metoprolol or carvedilol) with stable systolic heart failure

1.71

1.42–2.01

Respiratory system

Regular inhaled b-2agonist or antimuscarinic bronchodilator (e.g., ipratropium, tiotropium) for mild to moderate asthma or COPD

1.76

1.48–2.05

Regular inhaled corticosteroid for moderate–severe asthma or COPD

1.81

1.47–2.15

Home continuous oxygen with documented chronic hypoxaemia

2.10

1.71–2.47

Central nervous system and eyes

L-DOPA or a dopamine agonist in idiopathic Parkinson’s disease with functional impairment and resultant disability

2.00

1.54–2.46

Non-TCA antidepressant drug in the presence of persistent major depressive symptoms

1.86

1.47–2.25

Acetylcholinesterase inhibitor (e.g., donepezil, rivastigmine, galantamine) for mild–moderate Alzheimer’s dementia or Lewy Body dementia

2.05

1.63–2.47

Topical prostaglandin, prostamide or beta-blocker for primary open-angle glaucoma

2.05

1.68–2.41

Selective serotonin reuptake inhibitor (or SNRI or pregabalin if SSRI contraindicated) for persistent severe anxiety that interferes with independent functioning

1.95

1.58–2.32

Dopamine agonist (ropinirole or pramipexole or rotigotine) for Restless Legs Syndrome, once iron deficiency and severe renal failure have been excluded

2.43

2.03–2.82

Gastrointestinal

Proton Pump Inhibitor with severe gastro-oesophageal reflux disease or peptic stricture requiring dilatation

1.62

1.39–1.85

Fibre supplements (e.g., bran, ispaghula, methylcellulose, sterculia) for diverticulosis with a history of constipation

2.10

1.78–2.41

Musculoskeletal system

Disease-modifying anti-rheumatic drug (DMARD) with active, disabling rheumatoid disease

1.95

1.51–2.39

Bisphosphonates and vitamin D and calcium in patients taking long-term systemic corticosteroid therapy

2.33

1.92–2.75

Vitamin D and calcium supplement in patients with known osteoporosis and/or previous fragility fracture(s) and/or (Bone Mineral Density T-scores more than − 2.5 in multiple sites)

1.76

1.52–2.01

Bone anti-resorptive or anabolic therapy (e.g., bisphosphonate, teriparatide, denosumab) in patients with documented osteoporosis, where no pharmacological or clinical status contraindication exists (Bone Mineral Density T-scores—> 2.5 in multiple sites) and/or previous history of fragility fracture(s)

2.05

1.65–2.44

Vitamin D supplement in older people who are housebound or experiencing falls or with osteopenia (Bone Mineral Density T-score is > − 1.0

2.00

1.62–2.38

Xanthine–oxidase inhibitors (e.g., allopurinol, febuxostat) with a history of recurrent episodes of gout

1.95

1.68–2.22

Folic acid supplement in patients taking methotrexate

1.67

1.40–1.93

Endocrine

ACE inhibitor or Angiotensin Receptor Blocker (if intolerant of ACE inhibitor) in diabetes with evidence of renal disease, i.e., dipstick proteinuria or microalbuminuria (> 30 mg/24 h) with or without serum biochemical renal impairment

1.48

1.20–1.75

Urogenital

Alpha-1 receptor blocker with symptomatic prostatism, where prostatectomy is not considered necessary

1.95

1.59–2.32

5-Alpha reductase inhibitor with symptomatic prostatism, where prostatectomy is not considered necessary

2.00

1.68–2.32

Topical vaginal oestrogen or vaginal oestrogen pessary for symptomatic atrophic vaginitis

2.24

1.89–2.59

Opioids

High-potency opioids in moderate–severe pain, where paracetamol, NSAIDs or low-potency opioids are not appropriate to the pain severity or have been ineffective

1.81

1.58–2.04

Laxatives in patients receiving opioids regularly

1.71

1.36–2.07

Vaccines

Seasonal trivalent influenza vaccine annually

1.57

1.30–1.84

Pneumococcal vaccine at least once after age 65 according to national guidelines

1.62

1.31–1.92

Single dose of herpes zoster vaccines for people 60 years or older, with or without a prior episode of herpes zoster (shingles)**

2.10

1.72–2.47^a

Tetanus, diphtheria, and pertussis vaccines (TDaP) to be given to older adults 65 years and older**

2.14

1.81–2.47^a

Drugs that should not be restarted

Aspirin (75–160 mg once daily) in the presence of chronic atrial fibrillation, where Vitamin K antagonists or direct thrombin inhibitors or factor Xa inhibitors are contraindicated*

2.90

2.37–3.44^b