Prescribing cascades in community‐dwelling adults: A systematic review

Bibliographic Details
Title: Prescribing cascades in community‐dwelling adults: A systematic review
Authors: Ann S. Doherty, Faiza Shahid, Frank Moriarty, Fiona Boland, Barbara Clyne, Tobias Dreischulte, Tom Fahey, Seán P. Kennelly, Emma Wallace
Source: Pharmacology Research & Perspectives, Vol 10, Iss 5, Pp n/a-n/a (2022)
Publisher Information: Wiley, 2022.
Publication Year: 2022
Collection: LCC:Therapeutics. Pharmacology
Subject Terms: appropriate prescribing, community‐dwelling adults, prescribing cascades, systematic review, Therapeutics. Pharmacology, RM1-950
More Details: Abstract The misattribution of an adverse drug reaction (ADR) as a symptom or illness can lead to the prescribing of additional medication, referred to as a prescribing cascade. The aim of this systematic review is to identify published prescribing cascades in community‐dwelling adults. A systematic review was reported in line with the PRISMA guidelines and pre‐registered with PROSPERO. Electronic databases (Medline [Ovid], EMBASE, PsycINFO, CINAHL, Cochrane Library) and grey literature sources were searched. Inclusion criteria: community‐dwelling adults; risk‐prescription medication; outcomes‐initiation of new medicine to “treat” or reduce ADR risk; study type‐cohort, cross‐sectional, case‐control, and case‐series studies. Title/abstract screening, full‐text screening, data extraction, and methodological quality assessment were conducted independently in duplicate. A narrative synthesis was conducted. A total of 101 studies (reported in 103 publications) were included. Study sample sizes ranged from 126 to 11 593 989 participants and 15 studies examined older adults specifically (≥60 years). Seventy‐eight of 101 studies reported a potential prescribing cascade including calcium channel blockers to loop diuretic (n = 5), amiodarone to levothyroxine (n = 5), inhaled corticosteroid to topical antifungal (n = 4), antipsychotic to anti‐Parkinson drug (n = 4), and acetylcholinesterase inhibitor to urinary incontinence drugs (n = 4). Identified prescribing cascades occurred within three months to one year following initial medication. Methodological quality varied across included studies. Prescribing cascades occur for a broad range of medications. ADRs should be included in the differential diagnosis for patients presenting with new symptoms, particularly older adults and those who started a new medication in the preceding 12 months.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2052-1707
Relation: https://doaj.org/toc/2052-1707
DOI: 10.1002/prp2.1008
Access URL: https://doaj.org/article/d7e11c4b820a470d9a674355be7d317e
Accession Number: edsdoj.7e11c4b820a470d9a674355be7d317e
Database: Directory of Open Access Journals
More Details
ISSN:20521707
DOI:10.1002/prp2.1008
Published in:Pharmacology Research & Perspectives
Language:English