Preventing Prescribing Cascades: Ensuring Medication Safety for Older Adults

J Gerontol Nurs. 2024 Sep;50(9):7-11. doi: 10.3928/00989134-20240809-03. Epub 2024 Sep 1.

Abstract

Purpose: To define prescribing cascades (PCs) and provide tools to identify PCs, including the most common PCs described in the literature. PCs lead to the accumulation of medications prescribed to older adults, disproportionately affecting those who often have additional health care complexities, such as multiple chronic conditions and multiple transitions of care.

Method: Review of recent research efforts to identify and describe evolving clinical practice interventions to detect and reverse PCs.

Results: Clinicians can contribute to mitigating PCs through better understanding of how PCs occur in practice. Armed with this knowledge, clinical team members can implement proposed strategies and techniques to engage in primary and secondary prevention of PCs.

Conclusion: Ultimately, PCs are a culprit of preventable medication harm. Several tools are presented, which are initiated through maintaining a high index of suspicion for PCs in the evaluation of a new symptom presentation by older patients. [Journal of Gerontological Nursing, 50(9), 7-11.].

Publication types

  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Drug Prescriptions
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Female
  • Geriatric Nursing
  • Humans
  • Inappropriate Prescribing / prevention & control
  • Male
  • Medication Errors / prevention & control
  • Patient Safety*