Evidence map›Paper›PMID 41490470›Full record

ArticlePharmacoepidemiology and drug safety2026

Occurrence of Potential Prescribing Cascades After Hospital Discharge: A Cohort Study.

Atiya K Mohammad, Johanna H M Driessen, Jacqueline G Hugtenburg, Alex Marmorale, Carl Siegert, Patricia M L A van den Bemt, Petra Denig, Fatma Karapinar-Çarkıt

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Article in Pharmacoepidemiology and drug safety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Atiya K MohammadDepartment of Clinical Pharmacy, OLVG Hospital, Amsterdam, the Netherlands.
Johanna H M DriessenDepartment of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands.
Jacqueline G HugtenburgDepartment of Clinical Pharmacology and Pharmacy, Amsterdam UMC, VUMC, Amsterdam, the Netherlands.
Alex MarmoraleEpic Systems Corporation, Verona, Wisconsin, USA.
Carl SiegertDepartment of Internal Medicine, OLVG Hospital, Amsterdam, the Netherlands.
Patricia M L A van den BemtDepartment of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, Groningen, the Netherlands.
Petra DenigDepartment of Clinical Pharmacy and Pharmacology, University Medical Centre Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0002-7929-4739
Fatma Karapinar-ÇarkıtDepartment of Clinical Pharmacy, OLVG Hospital, Amsterdam, the Netherlands.ORCID https://orcid.org/0000-0002-3077-9663

Funding

OLVG 595507
6 · The paper itself

Abstract

purposeA prescribing cascade (PC) occurs when a medication (index) causes an adverse drug reaction (ADR), which is addressed by prescribing additional medication (marker). Medication initiated in the hospital may cause post-discharge ADRs and PCs, especially when multiple healthcare providers are involved. The study aimed to assess the cumulative incidence of potential PCs post-discharge and identify the healthcare providers involved in prescribing the marker medication.

methodsA cohort study was conducted among adult patients admitted in one hospital between 2019 and 2023, who initiated medication associated with preselected PCs (n = 20). A PC was defined as the initiation of a marker medication which may be intended to treat an ADR induced by the index medication. Data from the hospital and the Nationwide Medication Record System were used to identify potential PCs post-discharge. The primary outcome was the cumulative incidence of PCs, estimated for PCs with ≥ 10 patients initiating the index medication. The secondary outcome was the percentage of cases where the marker medication was prescribed by a healthcare provider outside the hospital, for PCs with ≥ 10 patients initiating the marker medication. Descriptive statistics were used.

resultsAmong 24 282 patients initiating index medication, 502 potential PCs were observed. The cumulative incidence was estimated for 17 PCs, ranging from 0% to 12.3%. Across 12 PCs with ≥ 10 patients, percentages of marker medications prescribed outside the hospital ranged from 31.8% to 92.8%.

conclusionThe cumulative incidence of potential PCs post-discharge can be substantial with marker medication often initiated by healthcare providers outside the hospital.

Indexed as

Drug PrescriptionsDrug-Related Side Effects and Adverse ReactionsPatient DischargePractice Patterns, Physicians'AdultAgedCohort StudiesFemaleHumansIncidenceMaleMiddle Agedcontinuity of carehospital dischargeinappropriate prescribingprescribing cascadestransitions in care

Identifiers

PMID41490470
PMCPMC12768529

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.