Prescription cascade

Prescription cascade is a medical phenomenon where the side effects of drugs are misinterpreted as symptoms of another problem, leading to the prescription of more medication. This can result in a cascade effect, with each new drug potentially causing side effects that are then treated with additional drugs.

Overview

The term prescription cascade was first coined in 1995 by Rochon and Gurwitz. It is a common issue in geriatric medicine, where patients are often on multiple medications due to chronic illnesses. The risk of a prescription cascade increases with the number of medications a patient is taking, a situation known as polypharmacy.

Causes

The main cause of prescription cascade is the misinterpretation of a drug's side effects as symptoms of a new medical condition. This can occur due to a lack of communication between different healthcare providers, or a lack of knowledge about the potential side effects of a medication. Other contributing factors include the over-reliance on medication to treat symptoms, and the tendency to prescribe medication as a first-line treatment.

Consequences

The consequences of a prescription cascade can be severe. It can lead to unnecessary medication use, increased healthcare costs, and a higher risk of adverse drug events. In some cases, it can also result in a decline in the patient's health and quality of life.

Prevention

Preventing a prescription cascade requires a thorough review of a patient's medication regimen, including the reasons for each medication and the potential side effects. This can be achieved through medication review and deprescribing, where unnecessary or harmful medications are discontinued. Patient education and improved communication between healthcare providers can also help prevent prescription cascades.

See also

• Adverse drug reaction
• Drug interaction
• Medication error
• Pharmacovigilance

External links

• Institute for Safe Medication Practices
• World Health Organization: Medication Safety

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