{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:28:57Z","timestamp":1787772537965,"version":"build-2784847793"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prescribing cascades occur when an adverse drug event is misinterpreted as a new medical condition, leading to the prescription of additional medications. They represent an important and preventable source of potentially inappropriate prescribing in older adults, yet their population-level incidence remains poorly documented in France.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide retrospective cohort study in 2022 using the French National Health Data System, including all individuals aged \u226565\u00a0years in 2022. Clinically important prescribing cascades were identified using a consensus-based list (ThinkCascades). Two complementary approaches were applied: a conservative longitudinal analysis and prescription sequence symmetry analysis. Incidence ranges were estimated, and subgroup analyses were performed to identify factors associated with cascade initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 16.6 million older adults, four of seven predefined potential prescribing cascades showed significant positive signals. The strongest associations were observed for benzodiazepine\u2013antipsychotic (adjusted sequence ratio [aSR] 2.48, 99% CI 2.44\u20132.51) and antipsychotic\u2013antiparkinsonian cascades (aSR 2.01, 99% CI 1.91\u20132.11). Incidence estimates ranged from 0.69% to 3.29%. Female sex, advanced age (\u226585\u00a0years), hospital initiation of the index drug and lack of prescriber continuity were associated with higher risks for specific cascades.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinically important potential prescribing cascades are common among older adults in France. These findings suggest potential prescribing cascades as a persistent and preventable contributor to medication-related harm and underscore the importance of systematic medication review, particularly during transitions of care and when new prescriptions shortly follow treatment initiation, as potential signals of prescribing cascades.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ageing\/afag254","type":"journal-article","created":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T11:33:21Z","timestamp":1786275201000},"source":"Crossref","is-referenced-by-count":0,"title":["Assessing incidence of clinically significantly prescribing cascades in older adults: a nationwide retrospective cohort study using the French National Health Data System"],"prefix":"10.1093","volume":"55","author":[{"given":"Fr\u00e9d\u00e9ric","family":"Gervais","sequence":"first","affiliation":[{"name":"Hospices Civils de Lyon, Department of Pharmacy, Charpennes Hospital , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]},{"name":"Hospices Civils de Lyon, Observatoires du M\u00e9dicament, des Dispositifs m\u00e9dicaux et des Innovations Th\u00e9rapeutiques (OMEDIT) Auvergne-Rh\u00f4ne-Alpes , Lyon, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]},{"name":"Hospices Civils de Lyon, Clinical Research Centre (CRC), VCF (Aging-Brain-Frailty), Charpennes Hospital, Department of Geriatric Medicine, Lyon Institute for Aging , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mence","family":"Vieille","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Department of Pharmacy, Charpennes Hospital , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsa","family":"Reallon","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Department of Pharmacy, Charpennes Hospital , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]},{"name":"Hospices Civils de Lyon, Clinical Research Centre (CRC), VCF (Aging-Brain-Frailty), Charpennes Hospital, Department of Geriatric Medicine, Lyon Institute for Aging , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]},{"name":"EA 7425 Health Services and Performance Research (HESPER), Univ Lyon 1 , Lyon ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2141-1442","authenticated-orcid":false,"given":"Thomas","family":"Morel","sequence":"additional","affiliation":[{"name":"Nantes Universite, D\u00e9partement de M\u00e9decine G\u00e9n\u00e9rale, UFR M\u00e9decine et Techniques M\u00e9dicales , Nantes, Pays de la Loire ,","place":["France"]},{"name":"Nantes Universite, INSERM, MethodS in Patients-Centered Outcomes and Health Research, SPHERE, Institut de Recherche en Sant\u00e9 2 (IRS2) , Nantes, Pays de la Loire ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christelle","family":"Mouchoux","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Department of Pharmacy, Charpennes Hospital , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]},{"name":"Hospices Civils de Lyon, Clinical Research Centre (CRC), VCF (Aging-Brain-Frailty), Charpennes Hospital, Department of Geriatric Medicine, Lyon Institute for Aging , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teddy","family":"Novais","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Department of Pharmacy, Charpennes Hospital , Villeurbanne, Auvergne-Rh\u00f4ne-Alpes ,","place":["France"]},{"name":"EA 7425 Health Services and Performance Research (HESPER), Univ Lyon 1 , Lyon 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