Research on prescribing cascades: a scoping review

Area of Science:

• Pharmacovigilance and Drug Safety
• Clinical Pharmacy Research
• Geriatric Pharmacology

Background:

• Prescribing cascades, a recognized issue for over two decades, exhibit varied research progress globally.
• International research on prescribing cascades lacks a unified approach, necessitating a systematic evaluation.
• This study aims to assess the current landscape of original research on prescribing cascades.

Purpose of the Study:

• To systematically evaluate the global research status of prescribing cascades.
• To identify research gaps and provide references for future studies.
• To inform improvements in clinical practice for medication safety.

Main Methods:

• Comprehensive literature search across 3 English and 4 Chinese databases until January 2022.
• Independent data extraction and descriptive analysis of 32 eligible studies.
• Comparative analysis of methodologies and findings from included research.

Main Results:

• 32 studies involving over 7 million patients across 11 countries were analyzed.
• Research primarily focused on elderly populations, with 49 identified prescribing cascade routes.
• Cardiovascular system and dementia were common, often involving calcium channel blockers.

Conclusions:

• Prescribing cascades are gaining international attention, particularly in the elderly with cardiovascular and neurological conditions.
• Integral research is lacking for special populations like children and pregnant women.
• Further in-depth studies and effective interventions are crucial to reduce prescribing cascade incidence.