{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:58:30Z","timestamp":1781074710474,"version":"3.54.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Pharmacol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Prescribing cascades occur when an adverse drug reaction (ADR) of a first medication is treated with a second medication, potentially leading to polypharmacy and harm. While various interventions are recommended to prevent harm, it is unknown which are implemented in daily practice. This study aims to assess the interventions implemented for ADRs of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study analysed secondary data from spontaneous ADR reports submitted to the Netherlands Pharmacovigilance Center Lareb. Reports were included if the ADR was suspected to be caused by an ACE inhibitor or ARB and an intervention was documented. The primary outcome was the proportion of ADRs treated with (1) dose reduction, (2) discontinuation of the suspected medication, (3) discontinuation followed by medication to treat the ADR, (4) switching to alternative medication, or (5) addition of marker medication (prescribing cascade). The secondary outcome was the proportion of ADRs resolved at the time of the ADR report.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 902 ADR reports were included. The most frequent intervention was discontinuing the suspected medication, followed by introducing medication to treat the ADR (42.5%), resulting in a large proportion of resolved ADRs (46.5%). However, 11.9% of reports included prescribing cascades, resolving the ADR in only 25.2% of reports.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Using real-world pharmacovigilance data, this study offers valuable insights into the treatment of ADRs of ACE inhibitors and ARBs in daily practice. Further research is needed to establish the most effective interventions for specific types of ADRs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00228-026-04088-6","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T03:28:01Z","timestamp":1780457281000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary data analysis of Adverse Drug Reactions reported by healthcare professionals and patients: interventions to manage ADRs of ACE inhibitors and ARBs"],"prefix":"10.1007","volume":"82","author":[{"given":"S. H.","family":"Spronk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. T. H.","family":"Nielen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Heier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Jessurun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Karapinar -\u00c7arkit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"issue":"8966","key":"4088_CR1","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/S0140-6736(95)92656-9","volume":"346","author":"PA Rochon","year":"1995","unstructured":"Rochon PA, Gurwitz JH (1995) Drug therapy. Lancet 346(8966):32\u201336","journal-title":"Lancet"},{"issue":"5","key":"4088_CR2","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1111\/jgs.15800","volume":"67","author":"LM McCarthy","year":"2019","unstructured":"McCarthy LM, Visentin JD, Rochon PA (2019) Assessing the Scope and Appropriateness of Prescribing Cascades. J Am Geriatr Soc 67(5):1023\u20131026","journal-title":"J Am Geriatr Soc"},{"key":"4088_CR3","unstructured":"Zorginstituut Nederland Voorschrijfcascades: Farmacotherapeutisch Kompas; Available from: https:\/\/www.farmacotherapeutischkompas.nl\/farmacologie\/voorschrijfcascades"},{"key":"4088_CR4","doi-asserted-by":"crossref","unstructured":"Rochon PA, O'Mahony D, Cherubini A, Onder G, Petrovic M, Dalton, K, McCarthy LM, Sternberg SA, Zwas DR, Stall NM, Reppas-Rindlisbacher CE, van der Velde N, Hilmer SN, Wu W, Li J, Ly A, Gurwitz JH (2025) International expert panel's potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med 16(5):1573\u20131584","DOI":"10.1007\/s41999-025-01215-x"},{"key":"4088_CR5","doi-asserted-by":"publisher","first-page":"1147921","DOI":"10.3389\/fphar.2023.1147921","volume":"14","author":"Z Chen","year":"2023","unstructured":"Chen Z, Liu Z, Zeng L, Huang L, Zhang L (2023) Research on prescribing cascades: a scoping review. Front Pharmacol 14:1147921","journal-title":"Front Pharmacol"},{"issue":"2","key":"4088_CR6","doi-asserted-by":"publisher","first-page":"467","DOI":"10.1111\/jgs.18683","volume":"72","author":"PA Rochon","year":"2024","unstructured":"Rochon PA, Austin PC, Normand SL, Savage RD, Read SH, McCarthy LM et al (2024) Association of a calcium channel blocker and diuretic prescribing cascade with adverse events: A population-based cohort study. J Am Geriatr Soc 72(2):467\u2013478","journal-title":"J Am Geriatr Soc"},{"issue":"12","key":"4088_CR7","doi-asserted-by":"publisher","first-page":"1085","DOI":"10.1007\/s40266-023-01072-y","volume":"40","author":"O Adrien","year":"2023","unstructured":"Adrien O, Mohammad AK, Hugtenburg JG, McCarthy LM, Priester-Vink S, Visscher R et al (2023) Prescribing Cascades with Recommendations to Prevent or Reverse Them: A Systematic Review. Drugs Aging 40(12):1085\u20131100","journal-title":"Drugs Aging"},{"issue":"11","key":"4088_CR8","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.1111\/jgs.15543","volume":"66","author":"H Brath","year":"2018","unstructured":"Brath H, Mehta N, Savage RD, Gill SS, Wu W, Bronskill SE et al (2018) What Is Known About Preventing, Detecting, and Reversing Prescribing Cascades: A Scoping Review. J Am Geriatr Soc 66(11):2079\u20132085","journal-title":"J Am Geriatr Soc"},{"issue":"1","key":"4088_CR9","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1177\/2042098615615472","volume":"7","author":"AH Lavan","year":"2016","unstructured":"Lavan AH, Gallagher P (2016) Predicting risk of adverse drug reactions in older adults. Ther Adv Drug Saf 7(1):11\u201322","journal-title":"Ther Adv Drug Saf"},{"issue":"3","key":"4088_CR10","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1093\/ageing\/afw044","volume":"45","author":"R Palladino","year":"2016","unstructured":"Palladino R, Tayu Lee J, Ashworth M, Triassi M, Millett C (2016) Associations between multimorbidity, healthcare utilisation and health status: evidence from 16 European countries. Age Ageing 45(3):431\u2013435","journal-title":"Age Ageing"},{"issue":"582","key":"4088_CR11","doi-asserted-by":"publisher","first-page":"e12","DOI":"10.3399\/bjgp11X548929","volume":"61","author":"C Salisbury","year":"2011","unstructured":"Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA (2011) Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. Br J Gen Pract 61(582):e12\u201321","journal-title":"Br J Gen Pract"},{"issue":"5","key":"4088_CR12","doi-asserted-by":"publisher","first-page":"e01008","DOI":"10.1002\/prp2.1008","volume":"10","author":"AS Doherty","year":"2022","unstructured":"Doherty AS, Shahid F, Moriarty F, Boland F, Clyne B, Dreischulte T et al (2022) Prescribing cascades in community-dwelling adults: A systematic review. Pharmacol Res Perspect 10(5):e01008","journal-title":"Pharmacol Res Perspect"},{"issue":"44","key":"4088_CR13","first-page":"745","volume":"119","author":"T Dreischulte","year":"2022","unstructured":"Dreischulte T, Shahid F, Muth C, Schmiedl S, Haefeli WE (2022) Prescribing Cascades: How to Detect Them, Prevent Them, and Use Them Appropriately. Dtsch Arztebl Int 119(44):745\u2013752","journal-title":"Dtsch Arztebl Int"},{"issue":"1","key":"4088_CR14","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1002\/phar.2880","volume":"44","author":"F Shahid","year":"2024","unstructured":"Shahid F, Doherty A, Wallace E, Schmiedl S, Alexander GC, Dreischulte T (2024) Prescribing cascades in ambulatory care: A structured synthesis of evidence. Pharmacotherapy 44(1):87\u201396","journal-title":"Pharmacotherapy"},{"issue":"10","key":"4088_CR15","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1007\/s40266-022-00964-9","volume":"39","author":"LM McCarthy","year":"2022","unstructured":"McCarthy LM, Savage R, Dalton K, Mason R, Li J, Lawson A et al (2022) ThinkCascades: A Tool for Identifying Clinically Important Prescribing Cascades Affecting Older People. Drugs Aging 39(10):829\u2013840","journal-title":"Drugs Aging"},{"issue":"8\u20139","key":"4088_CR16","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1016\/j.zefq.2014.08.022","volume":"108","author":"E Swart","year":"2014","unstructured":"Swart E, Schmitt J (2014) [STandardized Reporting Of Secondary data Analyses (STROSA)\u2014a recommendation]. Z Evid Fortbild Qual Gesundhwes 108(8\u20139):511\u2013516","journal-title":"Z Evid Fortbild Qual Gesundhwes"},{"key":"4088_CR17","unstructured":"Bijwerkingencentrum Lareb Over Lareb. Available from: www.lareb.nl"},{"key":"4088_CR18","unstructured":"International Council for Harmonisation Medical Dictionary for Regulatory Activities (MedDRA). Available from: www.meddra.org"},{"key":"4088_CR19","unstructured":"Vereniging NI (2023) Anafylaxie en acuut angio-oedeem. Het Acute Boekje. Available from: https:\/\/www.hetacuteboekje.nl\/hoofdstuk\/anafylaxieenacuut-angio-oedeem\/anafylaxie_en_acuut_angio-oedeem.html"},{"key":"4088_CR20","doi-asserted-by":"crossref","unstructured":"Srisuriyachanchai W, Cox AR, Kampichit, S, Jarernsiripornkul N (2023) Severity and Management of Adverse Drug Reactions Reported by Patients and Healthcare Professionals: A Cross-Sectional Survey. Int J Environ Res Public Health 20(4):3725","DOI":"10.3390\/ijerph20043725"},{"issue":"3","key":"4088_CR21","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.1111\/bcp.15024","volume":"88","author":"A Kant","year":"2022","unstructured":"Kant A, van Hunsel F, van Puijenbroek E (2022) Numbers of spontaneous reports: How to use and interpret? Br J Clin Pharmacol 88(3):1365\u20131368","journal-title":"Br J Clin Pharmacol"}],"container-title":["European Journal of Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00228-026-04088-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00228-026-04088-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00228-026-04088-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:17:28Z","timestamp":1781072248000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00228-026-04088-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":21,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["4088"],"URL":"https:\/\/doi.org\/10.1007\/s00228-026-04088-6","relation":{},"ISSN":["0031-6970","1432-1041"],"issn-type":[{"value":"0031-6970","type":"print"},{"value":"1432-1041","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"7 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"162"}}