A new study, published in BMJ , reveals that common medications, from statins to iron supplements, are quietly setting off prescribing cascades that leave older adults unknowingly taking drugs to treat side effects of other drugs. A potentially inappropriate prescribing cascade (PIPC) happens when a medication’s side effect gets mistaken for a new health problem, leading to another prescription that may not have been needed in the first place.
One common example flagged in the study involves non-steroidal anti-inflammatory drugs (NSAIDs). Commonly prescribed for pain, these drugs are associated with a rise in blood pressure, which can lead to a new prescription for high blood pressure, rather than a second look at the original pain medication. Older adults are especially vulnerable to this pattern because they're more likely to be on multiple medications at once, due to having multiple conditions, making it harder for both patients and clinicians to trace a new symptom back to an existing drug.
The PIPCs with the highest incidence were iron supplement to laxative, statins to pain reliever, and cholinesterase inhibitor (Common Uses:: Alzheimer's Disease: Prescribed to ease memory loss and cognitive decline in mild-to-severe dementia; Other Conditions: Used for neurodegenerative disorders like Parkinson's disease and muscle-weakening conditions like myasthenia gravis.) to sleep agent.
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