How many medications did you take today?
Nearly 4 in 10 adults over the age of 65 living in the United States are prescribed five or more medications. Polypharmacy, the use of five or more medications, is prevalent among older adults, especially women managing chronic conditions. Although these medications are often important and necessary, they can come with risks like harmful side-effects, drug interactions and adherence challenges.
Imagine someone with knee pain is prescribed a nonsteroidal anti-inflammatory drug as a pain reliever, but that causes a subsequent side-effect of high blood pressure that is misinterpreted as a new medical condition; this leads to the prescribing of potentially inappropriate medication to treat the hypertension. When physicians mistake the side-effect of a medication for symptoms of a new medical condition, and prescribe a subsequent drug to treat it, it is known as initiating a “prescribing cascade.”
Prescribing cascades play an important role in polypharmacy. Recognizing these cascades is vital for healthcare providers to inform their medication reviews, and possibly, deprescribe medications.
Over 160 prescribing cascades have been identified, revealing how potentially inappropriate prescribing can be harmful. Women’s Age Lab’s most recent study emphasizes the impact of prescribing cascades on potential healthcare use.
So, when a new medication is being considered or a patient’s medications are being reviewed, it is important to ask three questions:
1) Could an existing drug therapy be causing this new medical condition?
2) Could a lower dose be used or an alternative therapy initiated?
3) Is this drug needed at all?
By following these steps, potentially unnecessary medications can be reduced, side-effects can be mitigated and polypharmacy prevented.
To hear the audio podcast, visit:
https://academicminute.org/2024/04/paula-rochon-university-of-toronto-navigating-medication-awareness-for-a-healthier-tomorrow/
