Identifying prescribing cascades in Alzheimer's disease and related dementias: The calcium channel blocker-diuretic prescribing cascade.
Alzheimer's disease and related dementias
medication safety
older adults
prescribing cascade
Journal
Pharmacoepidemiology and drug safety
ISSN: 1099-1557
Titre abrégé: Pharmacoepidemiol Drug Saf
Pays: England
ID NLM: 9208369
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
received:
14
05
2020
accepted:
08
03
2021
pubmed:
15
3
2021
medline:
25
11
2021
entrez:
14
3
2021
Statut:
ppublish
Résumé
Prescribing cascades occur when a physician prescribes a new drug to address the side-effect of another drug. Persons with Alzheimer's disease and related dementias (ADRD) are at increased risk for prescribing cascades. Our objective was to develop an approach to estimating the proportion of calcium channel blocker-diuretic (CCB-diuretic) prescribing cascades among persons with ADRD in two U.S. health plans. We identified patients aged ≥50 on January 1, 2017, dispensed a drug to treat ADRD in the 365-days prior to/on cohort entry date. Patients had medical/pharmacy coverage for 1 year before and through cohort entry. We excluded individuals with an institutional stay encounter in the 45 days prior to cohort entry and censored patients based on: disenrollment from coverage, death, or end of data. We identified incident and prevalent CCB use in the 183-days following cohort entry, and identified subsequent incident diuretic use among incident and prevalent CCB-users within 365-days from cohort entry. There were 121 538 eligible patients. Approximately 62% were female, with a mean age of 79.5 (SD ±8.6). Overall 2.1% of the cohort experienced a prevalent CCB-diuretic prescribing cascade with 1586 incident diuretic-users among 36 462 prevalent CCB-users (4.3%, 95% CI 4.1-4.6%]); and there were161 incident diuretic-users among 3304 incident CCB-users (4.9%, 95% CI 4.2-5.7%) (incident CCB-diuretic cascade). We describe an approach to identify prescribing cascades in persons with ADRD, which can be used to assess the proportion of prescribing cascades in large cohorts. We determined the proportion of CCB-diuretic prescribing cascades was low.
Substances chimiques
Calcium Channel Blockers
0
Diuretics
0
Pharmaceutical Preparations
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1066-1073Subventions
Organisme : NIA NIH HHS
ID : R56 AG061813
Pays : United States
Informations de copyright
© 2021 John Wiley & Sons Ltd.
Références
Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: the prescribing cascade. BMJ. 1997;315:1096-1099.
Toure JT, Brandt NJ, Limcangco MR, Briesacher BA. Impact of second-generation antipsychotics on the use of antiparkinson agents in nursing homes and assisted-living facilities. Am J Geriatr Pharmacother. 2006;4:25-35.
Huh Y, Kim DH, Choi M, et al. Metoclopramide and Levosulpiride Use and Subsequent Levodopa Prescription in the Korean Elderly: The Prescribing Cascade. J Clin Med. 2019;8:1496.
McKean M, Pillans P, Scott IA. A medication review and deprescribing method for hospitalised older patients receiving multiple medications. Intern Med J. 2016;46:35-42.
Gill SS, Mamdani M, Naglie G, et al. A prescribing cascade involving cholinesterase inhibitors and anticholinergic drugs. Arch Intern Med. 2005;165:808-813.
Gagne JJ, Glynn RJ, Avorn J, Levin R, Schneeweiss S. A combined comorbidity score predicted mortality in elderly patients better than existing scores. J Clin Epidemiol. 2011;64:749-759.
Savage RD, Visentin JD, Bronskill SE, et al. Evaluation of a common prescribing cascade of calcium channel blockers and diuretics in older adults with hypertension. JAMA Intern Med. 2020;180(5):643-651. https://doi.org/10.1001/jamainternmed.2019.7087.
Lai EC, Pratt N, Hsieh CY, et al. Sequence symmetry analysis in pharmacovigilance and pharmacoepidemiologic studies. Eur J Epidemiol. 2017;32:567-582.
Vouri SM, Jiang X, Manini TM, et al. Magnitude of and characteristics associated with the treatment of calcium channel blocker-induced lower-extremity edema with loop diuretics. JAMA Netw Open. 2019;2:e1918425.
Vouri SM, van Tuyl JS, Olsen MA, Xian H, Schootman M. An evaluation of a potential calcium channel blocker-lower-extremity edema-loop diuretic prescribing cascade. J Am Pharm Assoc. 2018;58:534-539.
McCarthy LM, Visentin JD, Rochon PA. Assessing the scope and appropriateness of prescribing cascades. J Am Geriatr Soc. 2019;67:1023-1026.
Makani H, Bangalore S, Romero J, et al. Peripheral edema associated with calcium channel blockers: incidence and withdrawal rate-a meta-analysis of randomized trials. J Hypertens. 2011;29:1270-1280.
Wilkinson T, Ly A, Schnier C, et al. Identifying dementia cases with routinely collected health data: a systematic review. Alzheimers Dement. 2018;14(8):1038-1051. https://doi.org/10.1016/j.jalz.2018.02.016.