Initiation of NSAIDs or antihypertensives significantly increased the likelihood of subsequent prochlorperazine prescription, with adjusted sequence ratios ranging from 1.27 to 1.81.
Observational (n=514,056)
Does the initiation of antihypertensives or NSAIDs increase the risk of subsequent prochlorperazine prescription in older adults?
Initiation of antihypertensives or NSAIDs in older adults is associated with a significantly increased risk of subsequent prochlorperazine prescription, highlighting a potential prescribing cascade driven by unrecognized adverse drug reactions.
Effect estimate: aSR 1.27-1.81 (95% CI 1.16-2.19)
NSAID and antihypertensive-induced ADRs such as dizziness or nausea may contribute to subsequent prochlorperazine initiation among adults who are older, representing a potential prescribing cascade. Further research examining data that include clinical indications for prescribing is needed to confirm whether these signals represent true prescribing cascades or prescribing for another reason. ADRs should be included in the differential diagnosis for people who are older presenting with new symptoms in primary care.
Gilmore et al. (Sat,) conducted a observational in Potential prescribing cascades (adverse drug reactions to antihypertensives or NSAIDs) (n=514,056). Antihypertensives or NSAIDs vs. Reverse sequence (prochlorperazine initiated before antihypertensives or NSAIDs) was evaluated on Subsequent prochlorperazine prescription (adjusted sequence ratio) (aSR 1.27-1.81, 95% CI 1.16-2.19). Initiation of NSAIDs or antihypertensives significantly increased the likelihood of subsequent prochlorperazine prescription, with adjusted sequence ratios ranging from 1.27 to 1.81.