Medication safety - factors predisposing to polypharmacy including the ‘therapeutic cascade’ and the process for deprescribing

Polypharmacy

Polypharmacy (particularly problematic when medications accumulate without ongoing indication review) often develops through a prescribing cascade - a new drug is started to treat the side effect of an existing drug, which is misattributed to a new medical condition rather than recognised as an adverse effect, adding a medication rather than addressing or stopping the causative one
Increasingly common given rising multimorbidity and an ageing population, with polypharmacy itself becoming an independent risk factor for adverse drug events, falls, and hospitalisation, particularly in older adults

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