Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study
Introduction: A prescribing cascade occurs when new medications are prescribed to address an adverse drug reaction (ADR) associated with the preceding use of a medication, which may be mistaken as the onset of a novel disease or condition. The aim of this study was to evaluate the perceptions of ho...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Journal of Infection in Developing Countries
2025-01-01
|
| Series: | Journal of Infection in Developing Countries |
| Subjects: | |
| Online Access: | https://jidc.org/index.php/journal/article/view/19554 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850148809889284096 |
|---|---|
| author | Mahnoor Asad Waseem Ullah Márió Gajdács Melinda Madléna Suresh Shanmugham Sajesh K Veettil Shazia Q Jamshed |
| author_facet | Mahnoor Asad Waseem Ullah Márió Gajdács Melinda Madléna Suresh Shanmugham Sajesh K Veettil Shazia Q Jamshed |
| author_sort | Mahnoor Asad |
| collection | DOAJ |
| description |
Introduction: A prescribing cascade occurs when new medications are prescribed to address an adverse drug reaction (ADR) associated with the preceding use of a medication, which may be mistaken as the onset of a novel disease or condition. The aim of this study was to evaluate the perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades.
Methodology: A qualitative, semi-structured interview, followed by a quantitative, questionnaire-based study, was carried out at the Shifa International Hospital (SIH; Islamabad, Pakistan). Discharge summaries of patients aged ≥ 60 years were collected to assess the prevalence of polypharmacy at SIH.
Results: Discharge summaries of n = 350 patients were collected; 60.2% (n = 211) had comorbid conditions, and the co-occurrence of diabetes and hypertension were the most common. 37.8% (n = 132) were taking 8 or more medications. Eight (n = 8) hospital pharmacists participated in the qualitative study, and 4 major themes were identified in their perceptions regarding prescribing cascades. Fifty-two (n = 52) pharmacists were recruited in the quantitative phase. 86.5% (n = 45) of the participants reported long standing illness/chronic conditions; 67.3% (n = 35) noted the presence of comorbidities as a high risk, while 90.3% (n = 47) noted multiple prescribers, and 75.0% (n = 39) identified the ageing population as important risks factors for polypharmacy.
Conclusions: The current research may inform the role and responsibilities of hospital pharmacists in outpatient and inpatient departments, and in interprofessional care teams, in preventing and minimizing prescribing cascades.
|
| format | Article |
| id | doaj-art-9ef7a1560e944ceabb5cee7945821e78 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-9ef7a1560e944ceabb5cee7945821e782025-08-20T02:27:07ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802025-01-01190110.3855/jidc.19554Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method studyMahnoor Asad0Waseem Ullah1Márió Gajdács2Melinda Madléna3Suresh Shanmugham4Sajesh K Veettil5Shazia Q Jamshed6Department of Pharmacy Practice, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, PakistanDepartment of Pharmacy Practice, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, PakistanDepartment of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Szeged, HungaryDepartment of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Szeged, HungarySchool of Pharmacy, International Medical University, Kuala Lumpur, MalaysiaSchool of Pharmacy, International Medical University, Kuala Lumpur, MalaysiaDepartment of Pharmacy Practice, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan Introduction: A prescribing cascade occurs when new medications are prescribed to address an adverse drug reaction (ADR) associated with the preceding use of a medication, which may be mistaken as the onset of a novel disease or condition. The aim of this study was to evaluate the perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades. Methodology: A qualitative, semi-structured interview, followed by a quantitative, questionnaire-based study, was carried out at the Shifa International Hospital (SIH; Islamabad, Pakistan). Discharge summaries of patients aged ≥ 60 years were collected to assess the prevalence of polypharmacy at SIH. Results: Discharge summaries of n = 350 patients were collected; 60.2% (n = 211) had comorbid conditions, and the co-occurrence of diabetes and hypertension were the most common. 37.8% (n = 132) were taking 8 or more medications. Eight (n = 8) hospital pharmacists participated in the qualitative study, and 4 major themes were identified in their perceptions regarding prescribing cascades. Fifty-two (n = 52) pharmacists were recruited in the quantitative phase. 86.5% (n = 45) of the participants reported long standing illness/chronic conditions; 67.3% (n = 35) noted the presence of comorbidities as a high risk, while 90.3% (n = 47) noted multiple prescribers, and 75.0% (n = 39) identified the ageing population as important risks factors for polypharmacy. Conclusions: The current research may inform the role and responsibilities of hospital pharmacists in outpatient and inpatient departments, and in interprofessional care teams, in preventing and minimizing prescribing cascades. https://jidc.org/index.php/journal/article/view/19554prescribing cascadepolypharmacyadverse drug reactionhospital pharmacistshealthcare professionalmixed-methods |
| spellingShingle | Mahnoor Asad Waseem Ullah Márió Gajdács Melinda Madléna Suresh Shanmugham Sajesh K Veettil Shazia Q Jamshed Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study Journal of Infection in Developing Countries prescribing cascade polypharmacy adverse drug reaction hospital pharmacists healthcare professional mixed-methods |
| title | Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study |
| title_full | Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study |
| title_fullStr | Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study |
| title_full_unstemmed | Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study |
| title_short | Perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades: a mixed-method study |
| title_sort | perceptions of hospital pharmacists regarding roles in preventing and minimizing prescribing cascades a mixed method study |
| topic | prescribing cascade polypharmacy adverse drug reaction hospital pharmacists healthcare professional mixed-methods |
| url | https://jidc.org/index.php/journal/article/view/19554 |
| work_keys_str_mv | AT mahnoorasad perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy AT waseemullah perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy AT mariogajdacs perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy AT melindamadlena perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy AT sureshshanmugham perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy AT sajeshkveettil perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy AT shaziaqjamshed perceptionsofhospitalpharmacistsregardingrolesinpreventingandminimizingprescribingcascadesamixedmethodstudy |