Scholarlink

<p>A prescribing cascade occurs when an adverse drug reaction (ADR) generated from an index drug (Drug A) is mistaken for a new medical condition that is in turn managed with a new drug prescription (Drug B). Prescribing cascades represent a factor influencing inappropriate prescribing and unnecessary polypharmacy, especially among older adults. Using the REPOSI registry, we conduct a retrospective observational study to examine the prevalence of potential prescribing cascades, as identified in the ThinkCascades framework, among patients aged ≥ 65&#xa0;years admitted to geriatric or internal medicine wards. Evaluation was made at (i) admission, (ii) discharge, and (iii) at the 3&#xa0;month follow-up. At admission the prescribing cascade was defined as “not-determined” owing to the unavailability of sequential prescription information, while at discharge or 3&#xa0;month follow-up the cascade was defined as “introduced” when the marker medication (Drug B) was prescribed after the index medication (Drug A). At admission, among the REPOSI population of 10,253 hospitalized patients, 13.0% of them (1,335 cases) showed at least one “not-determined” prescribing cascade, with major prevalence for calcium channel blockers (CCBs) combined with diuretics (<i>n</i> = 932, 65.6%). During hospitalization, a total of 305 potential prescribing cascades were introduced, but 474 not-determined cascades were deprescribed at discharge. Three months after discharge, 31 new cases of potential prescribing cascades were introduced. For four out of nine prescribing cascades, low or no cases were found in all three situations. The proportion of patients exposed to potentially inappropriate prescribing cascades was relatively low. However, these findings highlight the need for practical tools to support physicians in preventing inappropriate prescribing.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prescribing cascades among hospitalized older adults: a retrospective cohort study from the REPOSI registry

  • 期刊论文

  • 发表日期：

    2026年5月12日

查看全文
  • Alice Restelli,
  • Chiara Crippa,
  • Alessandro Nobili,
  • Pier Mannuccio Mannucci,
  • Luca Pasina,
  • Alessandro Nobili,
  • Nicola Montano,
  • Giorgio Sesti,
  • Antonello Pietrangelo,
  • Antonio De Vincentis,
  • Alessandra Marengoni,
  • Mauro Tettamanti,
  • Luca Pasina,
  • Carlotta Franchi,
  • Francesca Orsini,
  • Massimo Cartabia,
  • Gabriella Miglio,
  • Alessia Antonella Galbussera,
  • Sara Mandelli,
  • Ilaria Ardoino,
  • Alessio Novella,
  • Sara Ratti,
  • Enrico Nicolis,
  • Domenico Prisco,
  • Elena Silvestri,
  • Giacomo Emmi,
  • Irene Mattioli,
  • Matteo Mazzetti,
  • Edoardo Biancalana,
  • Gianni Biolo,
  • Giacomo Bartelloni,
  • Ilaria Martini,
  • Luca Messana,
  • Filippo Mearelli,
  • Domenico Girelli,
  • Fabiana Busti,
  • Giacomo Marchi,
  • Nicola Veronese,
  • Mario Barbagallo,
  • Ligia Dominguez,
  • Vincenza Beneduce,
  • Federica Cacioppo,
  • Stefano Ciriminna,
  • Andrea Asaro,
  • Chiara Giannettino,
  • Claudia Canizzo,
  • Giovanna Ottavia Plano,
  • Anna Fazzari,
  • Alessandra Lo Nigro,
  • Ilenia Imbraguglio,
  • Sofia Contorno,
  • Salvatore Corrao,
  • Giuseppe Natoli,
  • Salvatore Mularo,
  • Valentina Orlando,
  • Giacomo Corrao,
  • Fabio Falcone,
  • Salvatore Scibetta,
  • Luigi Mirarchi,
  • Simona Amodeo,
  • Brenda Bongiorno,
  • Marco Zoli,
  • Maria Laura Matacena,
  • Giuseppe Orio,
  • Eleonora Magnolfi,
  • Giovanni Serafini,
  • Mattia Brunori,
  • Ilaria Lazzari,
  • Angelo Simili,
  • Tiziano Lucchi,
  • Paola Nicolini,
  • Gabriele Ghidini,
  • Miriana Martelengo,
  • Maddalena Fabrizi,
  • Giulia Vigani,
  • Arturo Cerizza,
  • Rita Deda,
  • Miriam Zappa,
  • Benedetta Carrelli,
  • Antonio Di Sabatino,
  • Emanuela Miceli,
  • Marco Vincenzo Lenti,
  • Lavinia Pitotti,
  • Valentina Antoci,
  • Ginevra Cambiè,
  • Costanza Caccia Dominioni,
  • Roberto Pontremoli,
  • Valentina Beccati,
  • Giulia Nobili,
  • Giovanna Leoncini,
  • Jacopo Alberto,
  • Federico Cattaneo,
  • Gerardo Mancuso,
  • Daniela Calipari,
  • Mosè Bartone,
  • Francesco Cipollone,
  • Maria Teresa Guagnano,
  • Ilaria Rossi,
  • Damiano D’Ardes,
  • Alessia Cipollone,
  • Riccardo Mattia Ricciardi,
  • Marco Bucci,
  • Paola Vizzarri,
  • Artenca Shehu,
  • Gerardo Mancuso,
  • Daniela Calipari,
  • Mosè Bartone,
  • Roberto Manetti,
  • Marta Chiara Sircana,
  • Maria Berria,
  • Alessandro Delitala,
  • Pierluigi Meloni,
  • Silvia Masala,
  • Maurizio Muscaritoli,
  • Alessio Molfino,
  • Antonella Giorgi,
  • Christian Gracin,
  • Giovanni Imbimbo,
  • Carmen Gallicchio,
  • Ottavio Martellucci,
  • Antonietta Gigante,
  • Chiara D’Elia,
  • Alessandra Marengoni,
  • Thelma Geneletti,
  • Eleonora Carlotti,
  • Arianna Pagani,
  • Claudia Capelli,
  • Antonio Picardi,
  • Umberto Vespasiani Gentilucci,
  • Paolo Gallo,
  • Jessica Avagliano,
  • Francesca Terracciani,
  • Giuseppe Bellelli,
  • Maurizio Corsi,
  • Lavinia Vitali,
  • Armida Soccali,
  • Alberto Finazzi,
  • Eleonora Cucini,
  • Emma Esposito,
  • Franco Arturi,
  • Elena Succurro,
  • Melania Melina,
  • Federica Giofrè,
  • Francesca Cosentino,
  • Delia Chiarello,
  • Francesco Andreozzi,
  • Antonio Brucato,
  • Teresa De Falco,
  • Enrica Negro,
  • Martino Brenna,
  • Lucia Trotta,
  • Giovanni Lorenzo Squintani,
  • Giacomo Iacomelli,
  • Giulia Colazzo,
  • Francesco Cavaleri,
  • Giada Pallini,
  • Martina Pirola,
  • Arianna Antonioli,
  • Paolo Simioni,
  • Irene Bertozzi,
  • Sara Angela Malerba,
  • Camilla Portinari,
  • Giordano Antonello,
  • Cecilia Fortino,
  • Camilla Goffi,
  • Francesca Guidolin,
  • Roberto Manfredini,
  • Benedetta Boari,
  • Alfredo De Giorgi,
  • Ruana Tiseo,
  • Giulia Marta Viglione,
  • Caterina Savriè,
  • Giuseppe Paolisso,
  • Maria Rosaria Rizzo,
  • Claudia Catalano,
  • Irene Di Meo,
  • Michele Cerasuolo,
  • Nicola Pelligrino,
  • Claudio Borghi,
  • Federica Piani,
  • Federico Ruscelli,
  • Chiara Baldini,
  • Giulia Boni,
  • Carlo Sabbà,
  • Francesco Saverio Vella,
  • Patrizia Suppressa,
  • Alessio Comitangelo,
  • Emanuele Amoruso,
  • Carlo Custodero,
  • Giuseppe Re,
  • Chiara Maria Palmisano,
  • Luigi Fenoglio,
  • Christian Bracco,
  • Giulia Racca,
  • Alessia Valentina Giraudo,
  • Salvatore D’Agnano,
  • Giorgia Sasia,
  • Irene Ruocco,
  • Floriana Mao,
  • Alice Ferrua,
  • Chiara Candela,
  • Anna Ludovica Fracanzani,
  • Silvia Tiraboschi,
  • Annalisa Cespiati,
  • Giovanna Oberti,
  • Giordano Sigon,
  • Felice Cinque,
  • Lucia Colavolpe,
  • Jaqueline Currà,
  • Francesca Alletto,
  • Natalia Scaramellini,
  • Simona Leoni,
  • Alessandra Danuta Di Mauro,
  • Gianpaolo Benzoni,
  • Margherita Re,
  • Laura Vivi,
  • Valentina Scime,
  • Flora Peyvandi,
  • Raffaella Rossio,
  • Giulia Colombo,
  • Pasquale Agosti,
  • Erica Pagliaro,
  • Ciro Canetta,
  • Valeria Savojardo,
  • Giuliana Ceriani,
  • Christian Folli,
  • Fabrizio Montecucco,
  • Cristina Michelauz,
  • Elisa Schiavetta,
  • Chiara Olivero,
  • Simone Isoppo,
  • Curzia Tortorella,
  • Federico Carbone,
  • Luca Liberale,
  • Aurora Mazzocato,
  • Carola Caserza,
  • Anita Cennamo,
  • Nicola Lucio Liberato,
  • Tiziana Tognin,
  • Francesco Purrello,
  • Antonino Di Pino,
  • Salvatore Piro,
  • Maurizio Di Marco,
  • Nicoletta Miano,
  • Sabrina Scilletta,
  • Renzo Rozzini,
  • Francesca Mazzeo,
  • Giulia Cono,
  • Giulia Cesaroni,
  • Giuseppe Montrucchio,
  • Paolo Peasso,
  • Edoardo Favale,
  • Cesare Poletto,
  • Carl Margaria,
  • Maura Sanino,
  • Valeria Bianchi,
  • Beatrice Bovo,
  • Beatrice Brusasco,
  • Gabriele Giuliano,
  • Marco Angeleri,
  • Luigina Guasti,
  • Francesca Rotunno,
  • Luana Castiglioni,
  • Andrea Maresca,
  • Leonardo Campiotti,
  • Alessandra Grossi,
  • Roberto Davide Diprizio,
  • Francesco Dentali,
  • Veronica Behnke,
  • Gloria Cuni,
  • Elena Fedra Salati,
  • Marco Bertolotti,
  • Chiara Mussi,
  • Giulia Lancellotti,
  • Laura Orlandi,
  • Federica Di Zio,
  • Gabriele Luppi,
  • Francesca D’Imprima,
  • Chiara Mazza,
  • Claudia Grandi,
  • Chiara Ferrari,
  • Ambrogio Breschi,
  • Angela Sciacqua,
  • Maria Perticone,
  • Raffaele Maio,
  • Aleandra Scozzafava,
  • Valentino Condoleo,
  • Elvira Clausi,
  • Giuseppe Armentaro,
  • Alberto Panza,
  • Alessia Grandinetti,
  • Maria Rosa,
  • Carlo Alberto Pastura,
  • Pasquale Loiacono,
  • Mariarosangela Scarcelli,
  • Gianluca Moroncini,
  • Emanuele Filippini,
  • Devis Benfaremo,
  • Pietro Castellino,
  • Luca Zanoli,
  • Agostino Gaudio,
  • Anastasia Xourafa,
  • Concetta Spichetti,
  • Serena Torre,
  • Alfio Gennaro,
  • Lucrezia Taibi,
  • Francesca Ferrari,
  • Guido Moreo,
  • Silvia Prolo,
  • Gloria Pina,
  • Lorenzo Magni,
  • Sophia Ratzinger,
  • Alberto Ballestrero,
  • Fabio Ferrando,
  • Roberta Gonella,
  • Arianna Piccardo,
  • Andrea Bellodi,
  • Dejvis Kalaja,
  • Anna Linda Patti,
  • Giuseppe Famularo,
  • Patrizia Tarsitani,
  • Tiziana Morretti,
  • Andrea Aglitti,
  • Marcello Giuseppe Maggio,
  • Fulvio Lauretani,
  • Marco Salvi,
  • Chiara Cattabiani,
  • Elena Bronzoni,
  • Aida Hoxha,
  • Beatrice Tanzi,
  • Stefano Del Giacco,
  • Davide Firinu,
  • Giulia Costanzo,
  • Andrea Giovanni Ledda,
  • Matteo Benuzzi,
  • Salvatore Chessa,
  • Martina Bullita,
  • Anna Licata,
  • Giuseppe Montalto,
  • Filippo Alessandro Montalto,
  • Angelo Rizzo,
  • Silvia Como,
  • Valentina Virzì,
  • Giorgio Basile,
  • Antonino Catalano,
  • Federica Bellone,
  • Concetto Principato,
  • Angelo Cocuzza,
  • Annamaria Buda,
  • Francesco Corica,
  • Lorenzo Malatino,
  • Benedetta Stancanelli,
  • Valentina Terranova,
  • Salvatore Di Marca,
  • Rosario Di Quattro,
  • Lara La Malfa,
  • Rossella Caruso,
  • Ivan Isaia,
  • Federica Castelletti,
  • Matteo Regolo,
  • Clara Salmeri,
  • Nicolas Cardaci,
  • Alessandra Lanzafame,
  • Patrizia Mecocci,
  • Carmelinda Ruggiero,
  • Virginia Boccardi,
  • Pietro Minuz,
  • Luigi Fondrieschi,
  • Sarah Morellini,
  • Andrea Sartorio,
  • Mario Pirisi,
  • Gian Paolo Fra,
  • Daniele Sola,
  • Mattia Bellan,
  • Emilio Simeone,
  • Rosa Scurti,
  • Fabio Tolloso,
  • Roberto Tarquini,
  • Alice Valoriani,
  • Silvia Dolenti,
  • Giulia Vannini,
  • Francesco Cei,
  • Marco Gucci,
  • Antonella Fardus Al Refaie,
  • Virginia Morelli,
  • Fabio Salvadori,
  • Sergio Harari,
  • Chiara Lonati,
  • Federico Napoli,
  • Italia Aiello,
  • Gabriele Tarallo,
  • Chiara Apostolico,
  • Federico Tagariello,
  • Alessandro Lucidi,
  • Davide Elia,
  • Ferdinando Carlo Sasso,
  • Teresa Salvatore,
  • Lucio Monaco,
  • Carmen Ricozzi,
  • Francesca Coviello,
  • Maria Elena Corona,
  • Giovanni Di Lorenzo,
  • Serafina Schettino,
  • Christian Catalini,
  • Davide Nilo,
  • Ilaria Indiano,
  • Alberto Pilotto,
  • Federica Gandolfo,
  • Davide Gonella,
  • Federica Cacioppo,
  • Moreno Tresoldi,
  • Enrica Bozzolo,
  • Sarah Damanti,
  • Gaia Deonette,
  • Giulia Marazzi,
  • Rita Venezia,
  • Lorenzo Ciocca,
  • Jasmin Mahajne,
  • Chiara Calabrese,
  • Giusy Faggiano,
  • Marta Secci,
  • Martina Laffranchi,
  • Ilaria Vergine,
  • Alessandro Marinosci,
  • Cecilia Bussolari,
  • Giovanni Benanti,
  • Francesca Conti,
  • Filippo Sciammetta,
  • Rabia Saeedbhatti,
  • Paolo Pasquero,
  • Massimo Porta,
  • Miriam Gino,
  • Stefania Morra Di Cella,
  • Bianca Pari,
  • Edoardo Pace,
  • Alessandro De Salve,
  • Patrizia Tilocca,
  • Sebastiana Maria Atzori,
  • Alberto Moggi Pignone,
  • Giulia Bandini,
  • Maria Cristina De Santis,
  • Chiara Di Cencio,
  • Anna Lo Cricchio,
  • Maria Lorenza Muiesan,
  • Carolina De Ciuceis,
  • Stefano Tenore,
  • Fabio Cherubini,
  • Francesco Russomanno,
  • Nicola Liuzzi,
  • Sokol Rrodhe,
  • Alice Parisi,
  • Eleonora Croce,
  • Fiammetta Pagnozzi,
  • Emanuela Messa,
  • Francesca Gaia Bacchieri,
  • Gaetano Serviddio,
  • Antonino Davide Romano,
  • Gianluigi Vendemiale,
  • Francesco Bellanti,
  • Aurelio Lo Buglio,
  • Antonino Tuttolomondo,
  • Domenico Di Raimondo,
  • Edoardo Pirera,
  • Riccardo De Rosa,
  • Francesca Dassie,
  • Angelo Di Vincenzo,
  • Sara Brandolese,
  • Agostino Di Ciaula,
  • Carlo Custodero,
  • Antonino Noto,
  • Chiara Valentina Luglio,
  • Piero Portincasa,
  • Leonardo A. Sechi,
  • Cristiana Catena,
  • Gabriele Brosolo,
  • Stefano Marcante,
  • Andrea Da Porto,
  • Luca Bulfone,
  • Antonio Vacca,
  • Angelo Baldassare Cefalù,
  • Antonina Giammanco,
  • Carola Maria Gagliardo,
  • Elena Campello,
  • Chiara Simion,
  • Michela Zanetti,
  • Paolo De Colle,
  • on behalf of the REPOSI Investigators

摘要

A prescribing cascade occurs when an adverse drug reaction (ADR) generated from an index drug (Drug A) is mistaken for a new medical condition that is in turn managed with a new drug prescription (Drug B). Prescribing cascades represent a factor influencing inappropriate prescribing and unnecessary polypharmacy, especially among older adults. Using the REPOSI registry, we conduct a retrospective observational study to examine the prevalence of potential prescribing cascades, as identified in the ThinkCascades framework, among patients aged ≥ 65 years admitted to geriatric or internal medicine wards. Evaluation was made at (i) admission, (ii) discharge, and (iii) at the 3 month follow-up. At admission the prescribing cascade was defined as “not-determined” owing to the unavailability of sequential prescription information, while at discharge or 3 month follow-up the cascade was defined as “introduced” when the marker medication (Drug B) was prescribed after the index medication (Drug A). At admission, among the REPOSI population of 10,253 hospitalized patients, 13.0% of them (1,335 cases) showed at least one “not-determined” prescribing cascade, with major prevalence for calcium channel blockers (CCBs) combined with diuretics (n = 932, 65.6%). During hospitalization, a total of 305 potential prescribing cascades were introduced, but 474 not-determined cascades were deprescribed at discharge. Three months after discharge, 31 new cases of potential prescribing cascades were introduced. For four out of nine prescribing cascades, low or no cases were found in all three situations. The proportion of patients exposed to potentially inappropriate prescribing cascades was relatively low. However, these findings highlight the need for practical tools to support physicians in preventing inappropriate prescribing.