Abstract
BACKGROUND The misinterpretation of an adverse drug reaction as a new medical condition can lead to the prescribing of a subsequent drug, referred to as a prescribing cascade. With increasing levels of prescribing follows increased risk of prescribing cascades.
PURPOSE To collect known prescribing cascades from scientific literature, in order to investigate the prevalence of prescribing cascades in five acute admission wards in Denmark.
METHODS A literature search was conducted using PRISMA guidelines to create a list of known published prescribing cascades. The list served as a screening tool to investigate the prevalence of prescribing cascades among acute admission ward patients in five acute wards in Region Zealand, Denmark; three somatic and two psychiatric acute wards.
FINDINGS From the literature search, 37 studies were included to create the list of 97 known prescribing cascades. The final list consisted of 64 cascades when medicines not marketed in Denmark were excluded. During 14 days, 1273 patients (mean age 57,6 years, 51% women) were screened with the PC list as a tool, and found a prevalence of 18.8% of patients having a PC. Thus nearly every fifth patient admitted to the acute wards during the 14 days of screening, were experiencing a PC. Then the additional findings were included (PCs not described in literature, but identified through assessment of health care records), the prevalence was 23.5%. Overall, 88 types of PCs identified in patients. The number of medications and advanced age had a relation to the prevalence of PCs.
CONCLUSION Nearly every fifth patient admitted in the acute wards had at least one prescribing cascade. The majority of the prescribing cascades are known from literature and most are appropriate. However, in this cross-sectional study we found that one third of the prescribing cascades in the patients were inappropriate prescribing, and should be of focus during admission medication reviews by pharmacists.
PURPOSE To collect known prescribing cascades from scientific literature, in order to investigate the prevalence of prescribing cascades in five acute admission wards in Denmark.
METHODS A literature search was conducted using PRISMA guidelines to create a list of known published prescribing cascades. The list served as a screening tool to investigate the prevalence of prescribing cascades among acute admission ward patients in five acute wards in Region Zealand, Denmark; three somatic and two psychiatric acute wards.
FINDINGS From the literature search, 37 studies were included to create the list of 97 known prescribing cascades. The final list consisted of 64 cascades when medicines not marketed in Denmark were excluded. During 14 days, 1273 patients (mean age 57,6 years, 51% women) were screened with the PC list as a tool, and found a prevalence of 18.8% of patients having a PC. Thus nearly every fifth patient admitted to the acute wards during the 14 days of screening, were experiencing a PC. Then the additional findings were included (PCs not described in literature, but identified through assessment of health care records), the prevalence was 23.5%. Overall, 88 types of PCs identified in patients. The number of medications and advanced age had a relation to the prevalence of PCs.
CONCLUSION Nearly every fifth patient admitted in the acute wards had at least one prescribing cascade. The majority of the prescribing cascades are known from literature and most are appropriate. However, in this cross-sectional study we found that one third of the prescribing cascades in the patients were inappropriate prescribing, and should be of focus during admission medication reviews by pharmacists.
| Original language | English |
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| Publication date | 2024 |
| Number of pages | 1 |
| Publication status | Published - 2024 |
| Event | 9th PCNE Working Symposium 2024: Advancing the paradigm and visibility of pharmacy practice research - University of Basel, Basel, Switzerland Duration: 20 Jun 2024 → 22 Jun 2024 https://www.pcne.org/conference/33/9th-pcne-working-symposium-2024- |
Conference
| Conference | 9th PCNE Working Symposium 2024 |
|---|---|
| Location | University of Basel |
| Country/Territory | Switzerland |
| City | Basel |
| Period | 20/06/2024 → 22/06/2024 |
| Internet address |