Understanding Prescribing Cascades: Evaluating Risks and its Management

Keywords: Prescribing Cascade, Polyphamacy, Adverse Drug Event, Elderly Patients, Deprescribing


Prescribing cascade occurs when an adverse drug event is misinterpreted as a new medical condition resulting in a new medication being prescribed to treat the adverse drug event. A simple example is prescription of a proton pump inhibitor(PPIs) to counteract the acid reflux caused by non-steroidal anti-inflammatory drugs(NSAIDs). An interconnection between polypharmacy and prescribing cascade is established where both have a direct influence on each other. Prescribing cascade can affect people of any age but has shown to frequently affect the elderly patients. Assessment tools include both simpler ways like effective communication, clinical process mapping, NO TEARS checklist and complex algorithms like the Screening Tool for Potentially Inappropriate Prescriptions (STOPP), Beers criteria, Medication Appropriateness Index. Identifying and disrupting the prescribing cascade is an important, feasible, and undervalued opportunity to improve patient drug safety.


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Author Biographies

Mohita Chadha

Intern, Department of Public Health Dentistry, Himachal Dental College, Sundernagar

Jaismine Singh

Intern, Department of Public Health Dentistry, Himachal Dental College, Sundernagar


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DOI: 10.26440/IHRJ/0609.12553
Published: 2023-01-03
How to Cite
Mohita Chadha, Jaismine Singh. Understanding Prescribing Cascades: Evaluating Risks and its Management. IHRJ [Internet]. 2023Jan.3 [cited 2023Mar.20];6(9):RV4-RV7. Available from: https://ihrjournal.com/ihrj/article/view/553