December 23, 2025British Journal of Clinical Pharmacology0 citationsOpen Access
View Full PaperPrevalence and impact of prescribing cascades in community‐dwelling adults: Longitudinal analysis of the Irish longitudinal study on ageing (TILDA)
Key Points
- This research aims to evaluate the prevalence and impact of prescribing cascades in community-dwelling adults aged 50 and older.
- Conducted a prospective cohort study
- Participants aged ≥50 years from TILDA with data across three waves
- Identified nine prescribing cascades through multiple analysis sets
- Five out of nine ThinkCascades were identified
- 24 participants, or 2.1%, experienced at least one ThinkCascade
- Study suggests clinician awareness may contribute to low prevalence
Abstract
Prescribing cascades occur when medication is prescribed to prevent/treat the adverse effects of another medication and may be intentional/unintentional. This study examines the prevalence of nine prescribing cascades (ThinkCascades) in The Irish Longitudinal StuDy on Ageing (TILDA). A prospective cohort study examined those aged ≥50 years with three consecutive data collection waves ( N = 6118) recorded between Wave 1 (2009/2011) and Wave 5 (2018). Nine separate analysis sets were created, representing each ThinkCascade. Exposure was the incident use of Drug A at wave x. A prescribing cascade was defined as the incident use of Drug B at wave x + 1, with continued use of Drug A. Five out of nine ThinkCascades were identified over 9 years of follow‐up. Overall, 24 participants experienced at least one ThinkCascade, representing a 2.1% prevalence ( n = 1153 eligible). This low prevalence may indicate prescribers' awareness of prescribing cascades. Higher event rates are required to examine any association with adverse health outcomes.