title: Prescribing cascade. A proposed new way to evaluate it.
abstract: Prescribing cascade is defined as the situation in which a first drug administered to a patient causes adverse event signs and symptoms, that are misinterpreted as a new condition, resulting in a new medication being prescribed. The cascade may have multiple steps and differ in complexity and severity. Despite being well identified, prescribing cascade is an increasingly common problem in medical practice. It constitutes a warning about irrational use of medicines that puts health at risk and increases treatment costs if it is not taken into account. In this article, representative cases taken from Hospital General de Agudos Dr. Cosme Argerich pharmacovigilance database were selected to assess a proper score and an algorithm that define the probable prescribing cascade.
authors.affiliation: Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina.|Cátedra de Farmacología, Facultad de Ciencias Médicas, Pontificia Universidad Católica, Buenos Aires, Argentina.
authors.forename: Marcelo L
authors.initials: ML
authors.lastname: Ponte
authors.affiliation: Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina.
authors.forename: Lionel
authors.initials: L
authors.lastname: Wachs
authors.affiliation: Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Wachs
authors.affiliation: Cátedra de Farmacología, Facultad de Ciencias Médicas, Pontificia Universidad Católica, Buenos Aires, Argentina. E-mail: haserrafarmaco@gmail.com.
authors.forename: Héctor A
authors.initials: HA
authors.lastname: Serra
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003657:Decision Making; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060735:Pharmacovigilance; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: adverse drug reaction; pharmacovigilance; polypharmacy; prescribing cascade