UBC Faculty Research and Publications

Reducing prescribing cascades University of British Columbia. Therapeutics Initiative


Therapeutics Letter 138 examines methods for reducing prescribing cascades. Conclusions: Prescribing cascades cause avoidable polypharmacy and harms. Prevent them by careful indication-based prescribing and screening for cascades during medication reviews. Utilize expert pharmacist or medical consultation when available. Start by familiarization with cascades involving drugs common in primary care; reduce doses if deprescribing seems too radical. Identifying a prescribing cascade is a teachable moment: use it.

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