Observational studyDrugs & aging2025
Detection of Potential Prescribing Cascades in Multimorbid Older Patients Hospitalised with Acute Illness-An Observational Prospective Prevalence Study.
Observational study in Drugs & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prescribing Cascades: An Umbrella Review and Updated Systematic Review.Drugs & aging · 2026Pooled it
- Article
- Prescribing cascades among hospitalized older adults: a retrospective cohort study from the REPOSI registry.Internal and emergency medicine · 2026Observational
- The association between disease status and health-related quality of life: evidence from a cross-sectional survey across mainland China.Health and quality of life outcomes · 2026Article
- Factors Influencing Hospital Physicians' Recognition of Prescribing Cascades: A Qualitative Interview Study.Drugs & aging · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrescribing cascades occur when a new drug is prescribed to treat an adverse drug event caused by an existing medication, resulting in unnecessary, or potentially hazardous additional drugs. To date, there are no published studies assessing the prevalence of prescribing cascades in older hospitalised adults.
objectiveTo investigate the prevalence of prescribing cascades in hospitalised older adults.
methodsWe conducted a prospective observational study of adults aged ≥ 65 years with multimorbidity and polypharmacy presenting to hospital with acute unselected medical or surgical illness. Prescribing cascades were identified using two predefined validated explicit cascade lists, i.e. ThinkCascades, and a list derived from a recently published systematic review of prescribing cascades in community-dwelling adults, referred to here as the 'Doherty list'. Potential prescribing cascades were classified as 'definite', 'probable', 'possible', 'uncertain' or 'indeterminate' according to pre-specified criteria.
resultsThe study included 385 consecutive patients (55.1% female, mean age 80.2 years, standard deviation 7.3 years). A total of 281 potential prescribing cascades (drug A → drug B) were identified in 152 patients (39.4%). Probable or possible prescribing cascades were identified in 48 patients (12.4%) using the Doherty list and in 44 patients (11.4%) using ThinkCascades. Patients exposed to potential prescribing cascades experienced greater levels of polypharmacy than patients not exposed to prescribing cascades (median interquartile range [IQR] of 12 [9-14] daily drugs versus 9 [IQR 7-11], p < 0.001).
conclusionsPotential prescribing cascades were highly prevalent in older hospitalised adults. Practical tools are needed to assist prescribers in prevention, recognition and management of inappropriate prescribing cascades.
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