Identifying Key Prescribing CASCADes in the Elderly: A Transnational Initiative on Drug Safety

Topic: Sex, Gender and Aging

Prescribing cascades occur when a health care provider misinterprets the side effect of a drug as a new medical condition and prescribes a second, potentially unnecessary, harmful drug to address the side effect. To improve the health of older adults, prescribing cascades must be identified and prevented. Since women live longer than men, they are more likely to be prescribed inappropriate drug therapies and experience more drug-related adverse events. To interrupt prescribing cascades, there is a need to understand sex and gender differences. In this international study, a team of experts in sex, gender and ageing will respond to this critical gap by applying a sex and gender lens to complementary health data from four countries. Specifically, we plan to evaluate whether men and women develop prescribing cascades in the same way and if there are differences in the ways they react from an adverse event. We will use administrative and clinical data on older adults to calculate prevalence rates for three prescribing cascades based on sex. We will also interview prescribers, patients and caregivers to explore how socially constructed gender roles contribute to the experience, presentation and management of prescribing cascades. Findings will lead to a greater understanding of how adverse drug events differ between older women and men, and help us develop and spread tailored knowledge translation products to minimize the frequency and impact of prescribing cascades.

Project’s ID

Project coordinator

Dr. Paula Rochon, MD, MPH, FRCPC, Vice President Research, Women’s College Hospital, Retired Teachers of Ontario Chair in Geriatric Medicine, Senior Scientist, Women’s College Research Institute, Professor, Department of Medicine, University of Toronto, Ontario, Canada

Countries Belgium, Canada, Ireland, Israel, Italy, USA.

Institutions involved Women’s College Hospital, University of Toronto, University College Cork, Istituto nazionale di ricovero e cura dell’anziano, Clalit Research Institute, University of Massachusetts (USA), University of Bologa (Italy), University of Sacro Cuore (Italy), University of Gent (Belgium).

Contact Paula Rochon, MD, MPH, FRCPC, paula.rochon@wchospital.ca