Study Finds 24 Common Drug Cascades Leading to Unnecessary Prescriptions in Ontario Seniors
Researchers identified 24 frequent prescribing cascades where a medication’s side effect is mistaken for a new condition, prompting additional drugs for older adults in Ontario.
An interdisciplinary team led by Dr. Paula Rochon analyzed Ontario prescription records and uncovered 24 common potentially inappropriate prescribing cascades, where a drug’s side effect is misinterpreted as a new health issue and treated with another medication. Examples include NSAIDs raising blood pressure, which is then addressed with antihypertensives instead of revising pain management. Older adults, particularly mature women, are most vulnerable due to polypharmacy and multiple chronic conditions.
The researchers propose enhanced medication reviews, greater pharmacist involvement, and clinical decision-support alerts to identify and stop these cascades before they cause harm or extra costs. The study, published in BMJ, draws on expertise from Canada, the United States, Europe, Israel and Ireland and utilizes data from ICES, Ontario’s health data institute.
Why it matters
Uncovering prescribing cascades can prevent avoidable drug harm and reduce healthcare costs for seniors.
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