ArticleBMC geriatrics2020
Patient and provider perspectives on the development and resolution of prescribing cascades: a qualitative study.
Article in BMC geriatrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Communication Processes Related to Decision-Making in Medication Management Between Healthcare Providers, Older People and Their Carers: A Systematic Review.Health expectations : an international journal of public participation in health care and health policy · 2025Pooled it
- Creating Awareness of preScribing Cascades and Managing Adverse Drug Effects (CASC-ADE) Tool: Appraisal by Future End Users.Drugs & aging · 2026Article
- Amiodarone- and Lithium-Induced Thyroid Dysfunction-Prescriber Specialties Involved in Potential Prescribing Cascades: A Retrospective Study.Health science reports · 2026Article
- Dose-dependent relationships in potential prescribing cascades: a cohort study using community pharmacy dispensing data.International journal of clinical pharmacy · 2026Article
- Prevalence and impact of prescribing cascades in community-dwelling adults: Longitudinal analysis of the Irish longitudinal study on ageing (TILDA).British journal of clinical pharmacology · 2026Article
- Decision-Making and Downstream Outcomes of the Gabapentinoid-Diuretic Prescribing Cascade.JAMA network open · 2025Article
- Factors Influencing Hospital Physicians' Recognition of Prescribing Cascades: A Qualitative Interview Study.Drugs & aging · 2025Article
- Loop diuretics and subsequent use of urinary symptom medications in older adults: evaluation of a possible prescribing cascade.The journals of gerontology. Series A, Biological sciences and medical sciences · 2025Article
- Real-World Complexity of Prescribing Cascades.Basic & clinical pharmacology & toxicology · 2025Review
- Pharmacy-led interventions to reverse and prevent prescribing cascades in primary care: a proof-of-concept study.International journal of clinical pharmacy · 2025Article
- Evaluation of Future Nurses' Beliefs and Fears About Pain: A Descriptive and Correlational Study.Journal of evaluation in clinical practice · 2025Article
- Article
- A-I-D for cascades: an application of the Behaviour Change Wheel to design a theory-based intervention for addressing prescribing cascades in primary care.Implementation science communications · 2024Article
- Article
- Which older adults are at highest risk of prescribing cascades? A national study of the gabapentinoid-loop diuretic cascade.Journal of the American Geriatrics Society · 2024Article
- Stakeholder perceptions of and attitudes towards problematic polypharmacy and prescribing cascades: a qualitative study.Age and ageing · 2024Article
- Evaluating Provider and Pharmacy Discordance in Potential Calcium Channel Blocker-Loop Diuretic Prescribing Cascade.Drugs & aging · 2024Article
- Continued potassium supplementation use following loop diuretic discontinuation in older adults: An evaluation of a prescribing cascade relic.Journal of the American Geriatrics Society · 2023Article
- Research on prescribing cascades: a scoping review.Frontiers in pharmacology · 2023Article
- "Kind of blurry": Deciphering clues to prevent, investigate and manage prescribing cascades.PloS one · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundPrescribing cascades occur when the side effect of a medication is treated with a second medication. The aim of the study was to understand how prescribing cascades develop and persist and to identify strategies for their identification, prevention and management.
methodThis qualitative study employed semi-structured interviews to explore the existence of prescribing cascades and to gather patients', caregivers' and clinicians' perspectives about how prescribing cascades start, persist and how they might be resolved. Participants were older adults (over age 65) at an outpatient Geriatric Day Hospital (GDH) with possible prescribing cascades (identified by a GDH team member), their caregivers, and healthcare providers. Data were analyzed using an inductive content analysis approach.
resultsFourteen participants were interviewed (eight patients, one family caregiver, one GDH pharmacist, three GDH physicians and one family physician) providing a total of 22 interviews about patient-specific cases. The complexity and contextually situated nature of prescribing cascades created challenges for all of those involved with their identification. Three themes impacted how prescribing cascades developed and persisted: varying awareness of medications and cascades; varying feelings of accountability for making decisions about medication-related care; and accessibility to an ideal environment and relevant information. Actions to prevent, identify or resolve cascades were suggested.
conclusionPatients and healthcare providers struggled to recognize prescribing cascades and identify when they had occurred; knowledge gaps contributed to this challenge and led to inaction. Strategies that equip patients and clinicians with resources to recognize prescribing cascades and environmental and social supports that would help with their identification are needed. Current conceptualizations of cascades warrant additional refinement by considering the nuances our work raises regarding their appropriateness and directionality.
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