Week 7 - Prescribing Cascade

Question 1

What is an iatrogenic prescribing cascade?

Answer 1

• practitioners adding medications to treat side effects

ie. when ADR misinterpreted as new medical condition, another drug is prescribed. Patient is treated again for the perceived medical condition, and sequence perpetuates new ADR

Question 2

Give an example of an iatrogenic prescribing cascade (2)

Answer 2

• an adverse effect of antihypertensives can be anxiety
• if the older adult is put on a med to reduce this anxiety, it is a prescribing cascade

Question 3

Why can health care providers initiate a prescribing cascade? (3, 7)

Answer 3

1. They lack information about medication from the older adult’s various sources medication
2. Lack of information about patient medical adherence
3. Lack of information about the older adult
   - change in weight
   - daily habit changes
   - Mental-emotional patterns
   - not recognizing ADR

Question 4

What are factors relating to the older adult that contribute to polypharmacy and misuse of medications? (3)

Answer 4

• social expectations
• psychosocial factors
• communication barriers

Question 5

What are factors relating to HCP that contribute to polypharmacy and misuse of medications? (3)

Answer 5

• do not spend the time to understand the physical changes
• prescribing cascade
• communication