A Multi-Method Approach to Exploring Prescribing Cascades

Prescribing cascades occur when a drug is used to treat the side effect of another drug. How and why prescribing cascades start and continue, their impact on people, and how they can be prevented or reversed are all unknown.

This research project is helping to identify strategies to prevent and reduce problematic polypharmacy caused by prescribing cascades. We have conducted two series of interviews with patients, caregivers and health care professionals to provide an in-depth analysis of behaviours to determine why prescribing cascades start and continue and what prevents them from being identified or better managed.

Using Michie’s Behaviour Change Wheel, our team is articulating behaviours that need to change and relevant strategies to identify prescribing cascades earlier, make them easier to manage or prevent them altogether. Our team will next gather stakeholder input on the feasibility of these strategies in practice.

Our goal is to help people identify prescribing cascades earlier or prevent them altogether in order to improve the health and well-being of older adults.

Lead: Dr. Barbara Farrell, Bruyère Research Institute

Co-investigators: Dr. Lianne Jeffs, Dr. Lisa McCarthy, Dr. Colleen Metge

Contact: deprescribing@bruyere.org

Funder (2017-2021): CIHR