iKASCADE Results

Publications & News

Jane E Brody

Shelley A SternbergMirko PetrovicGraziano OnderAntonio CherubiniDenis O’MahonyJerry H GurwitzFrancesco PegreffiRobin Mason, Jennifer Akerman, Lisa McCarthy Andrea Lawson ,Joyce Li , Wei WuPaula A Rochon

Prescribing cascades in older adults

Canadian Medical Association Journal, Podcast

Paula Rochon

Updates on the project

Dr. Paula Rochon, Project Coordinator of the iKASCADE transnational initiative, has launched Women’s Age Lab. The Lab, the first and only centre of its kind in the world, is a space for exploration and collaboration on science-driven health and social change that will improve the lives of older women. The aim is to enable researchers, healthcare providers and decision-makers, collectively with older women, to transform health and social care to positively impact their health and well-being. One of the four areas of focus of the Lab is to optimize drug therapies. As such, the work of iKASCADE – to identify and reduce prescribing cascades, a universal, yet under-researched, aspect of iatrogenic medication harm that particularly impacts older women – will contribute to Women’s Age Lab.

The iKASCADE Team are in the midst of preparing an abstract for submission for a symposium presentation at the 18th international European Geriatrics Medicine Society Congress to be held September 2022. The Team is proposing to discuss the process of applying a sex, age and gender lens across countries and diverse datasets throughout the iKASCADE work. The focus will be on challenges overcome and lessons learned.

Objectives updates

Knowledge translation of iKASCADE’s Objective 1 is well under way. This objective used an international modified Delphi process in order to develop an expert consensus-based short list of clinically important prescribing cascades (i.e., where risks of the prescribing cascade usually exceed benefits) impacting older people. This work is now complete. A manuscript detailing this Objective is currently under consideration for publication in Drugs & Aging, a peer-reviewed journal that publishes on drug therapy for an audience of researchers and healthcare professionals involved in the care of older patients. This work has also been presented at the 26th Congress of the European Association of Hospital Pharmacy in Vienna (March 2022) and will be presented at the American Geriatrics Society Meeting in Florida (May 2022).

The Objective 2 of the iKASCADE project is to utilize country-specific, complementary data sources to measure sex-stratified prevalence rates of nine key prescribing cascades and explore sex and gender differences in how prescribing cascades are experienced in different settings of care (community, hospital, or long-term care). We are well into this objective – data has been shared from Ireland, Israel and Italy, and we are in the midst of compiling this data in a comparative way with data from Canada.

We are on the cusp of launching a qualitative study in order to examine the role of gender in the development and maintenance of prescribing cascades, a goal that cuts across study objectives. The design of this innovative study was collaboratively produced, and the study itself will be run in Canada, Italy and Ireland. Results are anticipated for the end of the Summer 2022.