Common Drug Side Effects May Trigger Unnecessary Prescriptions
Researchers identified 24 common prescribing cascades in Ontario, where a side effect from one medication is mistaken for a new condition, leading to another prescription. Older adults are particularly vulnerable due to multiple medications. The study suggests that closer medication reviews and automated alerts could reduce these harmful sequences.
The research, published in BMJ, was led by Dr. Paula Rochon at Sinai Health and relied on prescription records from ICES. The team assessed 65 previously identified medication sequences using three metrics: how often the initial drug was dispensed, the frequency of a subsequent prescription, and the strength of the observed association.
An international panel of experts from five countries contributed to the initial list. One highlighted example involves pain relievers like NSAIDs, which can elevate blood pressure; this change may be misdiagnosed as hypertension, prompting an unnecessary new drug rather than a reassessment of the original treatment.
This research could reshape how clinicians review prescriptions for older adults, who may face compounding health risks from unnecessary drugs. By highlighting common chains, it may encourage more frequent pharmacist-led medication reviews and automated alert systems. Such measures could reduce avoidable healthcare spending and improve patient safety, though implementing these changes across diverse healthcare settings may require significant systemic adjustments.