Table 3.

Summary of patient cases

Drug/drug group	Agreement on clinical significance	Most common actions taken	Other comments
PPI	Yes	Reduce dose	While it is clinically significant, it is also a cost control concern
		Stop medication
Corticosteroids	Yes	Add medication
Long-term, long-acting benzodiazepines	Yes	Switch to alternative	Patient preference is an important factor. Availability of other services such as cognitive behavioural therapy is an important factor
		Reduce dose
NSAID	Yes	Stop medication
		Switch to alternative
Bladder antimuscarinics	No	Leave unaltered	Patient preference is an important factor. Lack of good alternative options available
		Switch to alternative
Tricyclic anti-depressants	No	Leave unaltered	Patient preference is an important factor
		Switch to alternative
		Reduce dose
Therapeutic duplications	Yes	Stop medication
		Switch to alternative
Calcium channel blocker	No	Switch to alternative
Theophylline	Yes	Stop medication

Abbreviations: NSAID Nonsteroidal anti-inflammatory drug, PPI Proton pump inhibitor.