Prescription cascade, a health problem
Keywords:
INAPPROPRIATE PRESCRIBING, DRUG-RELATED SIDE EFFECTS AND ADVERSE REACTIONS, POLIPHARMACY, DRUG RECALL.Abstract
Introduction: prescription cascade occurs when a new drug is prescribed to "treat" an adverse reaction associated with another drug; this prescription is based on the erroneous belief that a new medical condition requiring treatment has been established.
Objective: to identify patients presenting a cascade reaction, proposing new protocols for its prevention.
Method: a descriptive and cross-sectional study was conducted to identify the problem in the daily practice at Primary Health Care during the inter-consultations carried out at the four university polyclinics of Pinar del Rio municipality from April to October 2016. The cases were detected during the Comprehensive Geriatric Assessment. The criterion for geriatric patient and the number of medications consumed were taken into account. The target group was comprised of 144 patients, 60 years old and older, who were attended during the first consultation by means of comprehensive geriatric evaluation (n = 15). These patients were followed weekly for eight weeks, in each of the consultations the symptoms were assessed for the same reason they were consulted in the initial consultation.
Results: fifteen cases were diagnosed in which a cascade reaction was thought, and the diagnosis was subsequently confirmed once the drug was replaced, the doses were suspended or readjusted.
Conclusions: the follow-up of the patients during eight weeks allowed to obtain favorable results in relation to the symptoms referred at the commencement of the first Comprehensive Geriatric Assessment.
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References
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