Prescribing cascades potentially associated with harms before and after transition to long-term care facilities.
Background Transition to long-term care facilities (LTCFs) is a critical period associated with increases in medication errors and adverse events, yet our knowledge of prescribing cascades in the older population during this period is limited. The objective was to identify prescribing cascades poten...
| Publicado en: | Age & Ageing Vol. 55; no. 6; pp. 1 - 12 |
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| Autores principales: | , , , , |
| Formato: | Artículo |
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Oxford University Press / USA
Jun2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=195099715&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 195099715 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jun2026 vid: 55 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 195099715 10.1093/ageing/afag166 ppf: 1 ppct: 11 formats: tig: atl: Prescribing cascades potentially associated with harms before and after transition to long-term care facilities. aug: au: Hansen, Craig Ellet, Lisa Kalisch Air, Tracy Inacio, Maria C Caughey, Gillian Elizabeth affil: Registry of Senior Australians Research Centre, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, AustraliaRegistry of Senior Australians Research Centre, South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia School of Pharmacy and Biomedical Science, College of Health, Adelaide University, Australia su: Australia Elder care Drug side effects Retrospective studies Nursing care facilities Drugs Old age Prevention of drug side effects Inappropriate prescribing (Medicine) Risk assessment Mathematical variables Benzodiazepines Research funding Disease prevalence Polypharmacy Antipsychotic agents Tranquilizing drugs Descriptive statistics Transitional care Antidepressants Longitudinal method Physician practice patterns Research Medical records Acquisition of data Statins (Cardiovascular agents) Dementia Drug prescribing Confidence intervals Data analysis software sug: subj: Elder care Drug side effects Retrospective studies Nursing care facilities Drugs Old age Australia Continuing Care Retirement Communities Pharmaceutical and medicine manufacturing Medicinal and Botanical Manufacturing Drugs and Druggists' Sundries Merchant Wholesalers Pharmaceuticals and pharmacy supplies merchant wholesalers Nursing Care Facilities (Skilled Nursing Facilities) Community care facilities for the elderly Prevention of drug side effects Inappropriate prescribing (Medicine) Risk assessment Mathematical variables Benzodiazepines Research funding Disease prevalence Polypharmacy Antipsychotic agents Tranquilizing drugs Descriptive statistics Transitional care Antidepressants Longitudinal method Physician practice patterns Research Medical records Acquisition of data Statins (Cardiovascular agents) Dementia Drug prescribing Confidence intervals Data analysis software keyword: aged aged care copyrightHolder:British Geriatrics Society copyrightYear:2026 dementia https://dx.doi.org/10.1093/ageing/afag166 inLanguage:en long-term care medications older people prescribing behavior prescribing cascades publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42315166/ aged aged care copyrightHolder:British Geriatrics Society copyrightYear:2026 dementia https://dx.doi.org/10.1093/ageing/afag166 inLanguage:en long-term care medications older people prescribing behavior prescribing cascades publisher:Oxford University Press sameAs:https://pubmed.ncbi.nlm.nih.gov/42315166/ ab: Background Transition to long-term care facilities (LTCFs) is a critical period associated with increases in medication errors and adverse events, yet our knowledge of prescribing cascades in the older population during this period is limited. The objective was to identify prescribing cascades potentially associated with harm in LTCF residents before and after care entry. Methods A retrospective population-based cohort study of 167 850 individuals aged 65 years or older who entered 2771 LTCFs nationally between January 2018 and June 2020 was conducted. Prescription sequence symmetry analysis was used to examine 142 prescribing cascades with a 12-month exposure window between the index and marker medicines. Results Among 167 850 residents, 16.7% (n = 28 018) had at least one statistically significant prescribing cascade before transition to LTCF and 25.1% (n = 42 101) after LTCF, with little difference in prevalence when stratified by dementia status. Before LTCF entry, initiation of statins was associated with initiation of multiple medications [e.g. antipsychotics adjusted sequence ratio (aSR) 2.97, 95% confidence interval (CI) 2.58–3.41], antidepressants (aSR 1.60, 95% CI 1.45–1.76) and benzodiazepines were associated with initiation of antipsychotics (aSR 1.43, 95% CI 1.35–1.52). After LTCF entry, initiation of statins was associated with multiple medications (e.g. antipsychotics aSR 2.93, 95% CI: 2.59–3.3 and antidepressants aSR 2.29, 95% CI: 2.05–2.56). Initiation of benzodiazepines was associated with antipsychotics (aSR 1.53, 95% CI: 1.47–1.59). Six cascades prior to LTCF entry and 13 after were unique to residents living with dementia with many associated with insomnia/sedation. Conclusion This national population-based study identified prescribing patterns consistent with potential prescribing cascades during a vulnerable care transition. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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