Drug-induced Adverse Events and Prescribing Cascades in Older Adults: Pharmacy Stakeholder Survey

  • Scott Martin Vouri St. Louis College of Pharmacy
  • Kristine A. Reckenberg St. Louis College of Pharmacy
Keywords: drug-induced adverse events, education, prescribing cascade


Objectives: The aim of this study was to assess pharmacists’ and student pharmacists’ understanding of drug-induced adverse events (DIAEs) and prescribing cascades (PC) and assess their willingness to use system-level approaches to identify DIAEs and PC for future patient interventions.

Methods: Following a continuing education presentation on DIAEs and PC, pharmacists and student pharmacists completed a survey. A retrospective post-then-pre method was used to assess knowledge. McNemar tests and chi-square analyses were used to determine differences in understanding of DIAEs and PCs, as well as between pharmacists and student pharmacists.

Results: A total of 53 participants completed the survey including pharmacists (n=39) and student pharmacists (n=14). Fewer participants had previously heard of the term (40%; p<0.001) and concept (60%; p<0.001) of PC compared to the term and concept (98% in both) of DIAE. Student pharmacists were less likely to have heard of the term PC (14%) compared to pharmacists (40%; p=0.029). There was no difference in knowledge of the concept of PC. Nearly all respondents were willing to assess for DIAE and PC in their patients, and over 75% of respondents were willing to receive systems-based alerts for DIAE and PC.

Conclusion: There was a differential in understanding DIAE and PC among respondents. Programs aimed at building understanding, as well as systems-level alerts for PC, are needed.

Conflict of Interest

Disclosures: This author declare no conflicts of interest for this manuscript.

Support: This publication was supported by the Washington University Institute of Clinical and Translational Sciences grant UL1TR000448, sub-award KL2TR000450, from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH).


Type: Student Project


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Received 2017-01-30
Published 2017-06-30