{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T04:36:01Z","timestamp":1789878961890,"version":"4.0.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T00:00:00Z","timestamp":1701043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT\u2010153060"],"award-info":[{"award-number":["PJT\u2010153060"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prescribing cascades occur when a drug adverse event is misinterpreted as a new medical condition and a second, potentially unnecessary drug, is prescribed to treat the adverse event. The population\u2010level consequences of prescribing cascades remain unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This population\u2010based cohort study used linked health administrative databases in Ontario, Canada. The study included community\u2010dwelling adults, 66\u2009years of age or older with hypertension and no history of heart failure (HF) or diuretic use in the prior year, newly dispensed a calcium channel blocker (CCB). Individuals subsequently dispensed a diuretic within 90\u2009days of incident CCB dispensing were classified as the prescribing cascade group, and compared to those not dispensed a diuretic, classified as the non\u2010prescribing cascade group. Those with and without a prescribing cascade were matched one\u2010to\u2010one on the propensity score and sex. The primary outcome was a serious adverse event (SAE), which was the composite of emergency room visits and hospitalizations in the 90\u2010day follow\u2010up period. We estimated hazard ratios (HRs) with 95% confidence intervals (CI) for SAE using an Andersen\u2013Gill recurrent events regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 39,347 older adults with hypertension and no history of HF who were newly dispensed a CCB, 1881 (4.8%) had a new diuretic dispensed within 90\u2009days after CCB initiation. Compared to the non\u2010prescribing cascade group, those in the prescribing cascade group had higher rates of SAEs (HR: 1.21, 95% CI: 1.02\u20131.43).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CCB\u2010diuretic prescribing cascade was associated with an increased rate of SAEs, suggesting harm beyond prescribing a second drug therapy. Our study raises awareness of the downstream impact of the CCB\u2010diuretic prescribing cascade at a population level and provides an opportunity for clinicians who identify this prescribing cascade to review their patients' medications to determine if they can be optimized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18683","type":"journal-article","created":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T19:10:42Z","timestamp":1701112242000},"page":"467-478","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Association of a calcium channel blocker and diuretic prescribing cascade with adverse events: A population\u2010based cohort study"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5973-4151","authenticated-orcid":false,"given":"Paula A.","family":"Rochon","sequence":"first","affiliation":[{"name":"Women's Age Lab and Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"},{"name":"ICES  Toronto Ontario Canada"},{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management &amp; Evaluation, Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management &amp; Evaluation, Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon\u2010Lise","family":"Normand","sequence":"additional","affiliation":[{"name":"Department of Health Care Policy Harvard Medical School  Boston Massachusetts USA"},{"name":"Department of Biostatistics Harvard School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2746-373X","authenticated-orcid":false,"given":"Rachel D.","family":"Savage","sequence":"additional","affiliation":[{"name":"Women's Age Lab and Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"},{"name":"ICES  Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management &amp; Evaluation, Dalla Lana School of Public Health University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie H.","family":"Read","sequence":"additional","affiliation":[{"name":"Women's Age Lab and Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9087-1077","authenticated-orcid":false,"given":"Lisa M.","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Women's Age Lab and Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"},{"name":"Leslie Dan Faculty of Pharmacy University of Toronto  Toronto Ontario Canada"},{"name":"Institute for Better Health Trillium Health Partners  Mississauga Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasily","family":"Giannakeas","sequence":"additional","affiliation":[{"name":"Women's Age Lab and Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"},{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wu","sequence":"additional","affiliation":[{"name":"Women's Age Lab and Women's College Research Institute Women's College Hospital  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Strauss","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Wang","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Chen","sequence":"additional","affiliation":[{"name":"ICES  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry H.","family":"Gurwitz","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine UMass Chan Medical School  Worcester Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13844"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010147\u201011\u2010200712040\u201000006"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1103053"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1024\/0040\u20105930\/a000736"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92656-9"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7115.1096"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2021.08.003"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-022-00964-9"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2666-7568(21)00054-4"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.7087"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17312"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.7.808"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13820"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5230"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.18425"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18066"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877\u2010020\u201001774\u20107"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12714"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0272418"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40266\u2010021\u201000868\u20100"},{"key":"e_1_2_12_22_1","unstructured":"Statistics Canada.table 17\u201010\u20100005\u201001. 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