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https://www.rpr.lib.ok.us/taxonomy/term/11149/all en https://www.rpr.lib.ok.us/resource/identifying-and-quantifying-potentially-problematic-prescribing-cascades-clinical-practice <div class="field field-name-field-artifact-uploaded-date field-type-datetime field-label-inline clearfix"> <div class="field-label">Date Added:&nbsp;</div> <div class="field-items"> <div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-12-17T00:00:00-06:00">December 17, 2024</span></div> </div> </div> <div class="field field-name-field-artifact-journal field-type-text field-label-inline clearfix"> <div class="field-label">Journal/Publication:&nbsp;</div> <div class="field-items"> <div class="field-item even">J Am Geriatr Soc</div> </div> </div> <div class="field field-name-field-artifact-published-date field-type-datetime field-label-inline clearfix"> <div class="field-label">Publication Date:&nbsp;</div> <div class="field-items"> <div class="field-item even"><span class="date-display-single" property="dc:date" datatype="xsd:dateTime" content="2024-09-20T00:00:00-05:00">September 20, 2024</span></div> </div> </div> <div class="field field-name-field-artifact-issue field-type-text field-label-inline clearfix"> <div class="field-label">Issue:&nbsp;</div> <div class="field-items"> <div class="field-item even">12</div> </div> </div> <div class="field field-name-field-artifact-volume field-type-text field-label-inline clearfix"> <div class="field-label">Volume:&nbsp;</div> <div class="field-items"> <div class="field-item even">72</div> </div> </div> <div class="field field-name-field-artifact-pages field-type-text field-label-inline clearfix"> <div class="field-label">Pages:&nbsp;</div> <div class="field-items"> <div class="field-item even">3681-3694</div> </div> </div> <div class="field field-name-field-artifact-url field-type-link-field field-label-inline clearfix"> <div class="field-label">URL:&nbsp;</div> <div class="field-items"> <div class="field-item even"><a href="https://pubmed.ncbi.nlm.nih.gov/39305008/" target="_blank">Identifying and quantifying potentially problematic prescribing cascades in clinical practice: A mixed-methods study</a></div> </div> </div> <div class="field field-name-field-artifact-type field-type-taxonomy-term-reference field-label-inline clearfix"> <div class="field-label">Type:&nbsp;</div> <div class="field-items"> <div class="field-item even">Clinical Research Results</div> </div> </div> <div class="field field-name-field-artifact-format field-type-taxonomy-term-reference field-label-inline clearfix"> <div class="field-label">Format:&nbsp;</div> <div class="field-items"> <div class="field-item even">Article</div> </div> </div> <div class="field field-name-field-artifact-doi-1 field-type-text field-label-inline clearfix"> <div class="field-label">DOI (1):&nbsp;</div> <div class="field-items"> <div class="field-item even">10.1111/jgs.19191</div> </div> </div> <div class="field field-name-field-artifact-keywords field-type-taxonomy-term-reference field-label-above"> <div class="field-label">Keywords&nbsp;</div> <div class="field-items"> <div class="field-item even"><a href="/tags/adverse-drug-reaction" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">adverse drug reaction</a></div> <div class="field-item odd"><a href="/tags/appropriate-prescribing" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">appropriate prescribing</a></div> <div class="field-item even"><a href="/tags/pharmacotherapy" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">pharmacotherapy</a></div> <div class="field-item odd"><a href="/tags/prescribing-cascades" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">prescribing cascades</a></div> <div class="field-item even"><a href="/tags/prescription-sequence-symmetry-analysis" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">prescription sequence symmetry analysis</a></div> </div> </div> <div class="field field-name-field-artifact-pmid-1 field-type-text field-label-inline clearfix"> <div class="field-label">PMID (1):&nbsp;</div> <div class="field-items"> <div class="field-item even">39305008</div> </div> </div> <div class="field field-name-field-artifact-mesh field-type-taxonomy-term-reference field-label-above"> <div class="field-label">MeSH&nbsp;</div> <div class="field-items"> <div class="field-item even"><a href="/mesh/aged" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">aged</a></div> <div class="field-item odd"><a href="/mesh/aged-80-and-over" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Aged, 80 and over</a></div> <div class="field-item even"><a href="/mesh/drug-prescriptionsstatistics-numerical-data" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Drug Prescriptions/statistics &amp; numerical data</a></div> <div class="field-item odd"><a href="/mesh/inappropriate-prescribing-statistics-numerical-data" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Inappropriate Prescribing / statistics &amp; numerical data</a></div> <div class="field-item even"><a href="/mesh/practice-patterns" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Practice Patterns</a></div> <div class="field-item odd"><a href="/mesh/physicians-statistics-numerical-data" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Physicians&#039;* / statistics &amp; numerical data</a></div> </div> </div> <div class="field field-name-field-artifact-editor-note field-type-text-long field-label-hidden"> <div class="field-items"> <div class="field-item even"><p>A study that documents many of the common prescribing cascades involving older patients. James W. Mold, MD, MPH</p> </div> </div> </div> <div class="field field-name-field-artifact-text-availability field-type-list-text field-label-hidden"> <div class="field-items"> <div class="field-item even">Free full text</div> </div> </div> <div class="field field-name-field-artifact-document-content field-type-entityreference field-label-hidden"> <div class="field-items"> <div class="field-item even"><div class="view view-artifact-docs view-id-artifact_docs view-display-id-block view-dom-id-7164c4ab86c228a1d84f7f25bb6c9359"> <div class="view-content"> <div class="views-row views-row-1 views-row-odd views-row-first views-row-last"> <a href="https://pubmed.ncbi.nlm.nih.gov/39305008/" class="btn btn-primary" target="_blank">View</a> </div> </div> </div></div> </div> </div> <div class="field field-name-body field-type-text-with-summary field-label-hidden"> <div class="field-items"> <div class="field-item even" property="content:encoded"><p>Background: A prescribing cascade occurs when medication causes an adverse drug reaction (ADR) that leads to the prescription of additional medication. Prescribing cascades can cause excess medication burden, which is of particular concern in older adults. This study aims to identify and quantify potentially problematic prescribing cascades relevant for clinical practice.</p> <p>Methods: A mixed-methods study was conducted. First, prescribing cascades were identified through literature search. An expert panel (n = 16) of pharmacists and physicians assessed whether these prescribing cascades were potentially problematic. Next, a cohort study quantified potentially problematic prescribing cascades in adults using Dutch community pharmacy data for the period 2015-2020. Additionally, the influence of multiple medications potentially causing the same ADR was evaluated. Prescription sequence symmetry analysis was used to calculate adjusted sequence ratios (aSRs), adjusting for temporal prescribing trends. An aSR &gt;1.0 indicates the occurrence of a prescribing cascade. In a subgroup analysis, aSRs were calculated for older adults.</p> <p>Results: Seventy-six prescribing cascades were identified in literature and three were provided by experts. Of these, 66 (83.5%) were considered potentially problematic. A significant positive aSR for the medication sequence was found for 41 (62.1%) of these prescribing cascades. The highest aSR was found for amiodarone potentially causing hypothyroidism treated with thyroid hormones (4.63 [95% confidence interval 4.40-4.85]), based on 565 incident users. The biggest population (n = 34,645) was found for angiotensin converting enzyme-inhibitors potentially causing urinary tract infections treated with antibiotics. Regarding four potential ADRs, the aSRs were higher for people using multiple medications that cause the same ADR as compared to people using only one of those medications. Among older adults the aSRs remained significant for 37 prescribing cascades.</p> <p>Conclusion: An overview was generated of potentially problematic prescribing cascades relevant for clinical practice. These results can support healthcare providers to intervene and reduce medication burden for older adults.</p> </div> </div> </div> <div class="field field-name-field-resource-author field-type-taxonomy-term-reference field-label-inline clearfix"> <div class="field-label">Author/s:&nbsp;</div> <div class="field-items"> <div class="field-item even">Atiya K Mohammad, Jacqueline G Hugtenburg, Joost W Vanhommerig</div> </div> </div> Tue, 17 Dec 2024 19:30:20 +0000 Alex Haga 2493 at https://www.rpr.lib.ok.us