Community pharmacists’ awareness, identification, and management of prescribing cascades: A cross-sectional survey

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dc.contributor.authorDalton, Kieranen
dc.contributor.authorCallaghan, Roberten
dc.contributor.authorO'Sullivan, Niamhen
dc.contributor.authorMcCarthy, Lisaen
dc.date.accessioned2024-12-19T14:39:39Z
dc.date.available2024-12-19T14:39:39Z
dc.date.issued2024en
dc.description.abstractBackground: Prescribing cascades can lead to unnecessary medication use, healthcare costs, and patient harm. Pharmacists oversee prescriptions from multiple prescribers and are well positioned to identify such cascades, making pharmacists key stakeholders to address them. Objectives: To evaluate community pharmacists’ awareness, identification, and management of prescribing cascades and to assess behavioural determinants that may be targeted in future strategies to minimise inappropriate prescribing cascades. Methods: An online survey was developed using the Theoretical Domains Framework (TDF) and emailed to all registered community pharmacists in Ireland (n = 3775) in November 2021. Quantitative data were analysed using descriptive and inferential statistics. Free-text sections were given to capture reasons for non-resolution of identified prescribing cascades and suggestions to aid prescribing cascade identification and management; this text underwent content analysis. Results: Of the 220 respondents, 51% were aware of the term ‘prescribing cascade’ before the survey, whilst 69% had identified a potentially inappropriate prescribing cascade in practice. Over one third were either slightly confident (26.4%) or not confident at all (10%) in their ability to identify potentially inappropriate prescribing cascades in patients' prescriptions before the survey, whilst 55.2% were concerned that patients were receiving prescribing cascades they had not identified. Most respondents wanted further information/training to help prescribing cascade identification (88.3%) and management (86.1%). Four predominant TDF domains identified were common to both i) influencing non-resolution of identified prescribing cascades and ii) in the suggestions to help identify and manage prescribing cascades: ‘Environmental Context and Resources’, ‘Social/Professional Role and Identity’, ‘Social Influences’ and ‘Memory, Attention and Decision Processes’. Conclusions: There is a clear need to provide additional resources to help community pharmacists identify and manage prescribing cascades. These findings will support the development of theory-informed behaviour change strategies to aid the minimisation of inappropriate prescribing cascades and decrease the risk of medication-related harm for patients. © 2024en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationDalton, K., Callaghan, R., O'Sullivan, N. and McCarthy, L. (2024) 'Community pharmacists’ awareness, identification, and management of prescribing cascades: A cross-sectional survey', Research in Social and Administrative Pharmacy, 20(6), pp.102-112. https://doi.org/10.1016/j.sapharm.2024.02.013en
dc.identifier.doi10.1016/j.sapharm.2024.02.013en
dc.identifier.endpage112en
dc.identifier.issued6
dc.identifier.journaltitleResearch in Social and Administrative Pharmacyen
dc.identifier.startpage102en
dc.identifier.urihttps://hdl.handle.net/10468/16755
dc.identifier.volume20
dc.language.isoenen
dc.publisherElsevier Inc.en
dc.rightshttps://creativecommons.org/licenses/by/4.0/en
dc.subjectDrug therapyen
dc.subjectPharmacisten
dc.subjectPolypharmacyen
dc.subjectPrescribing cascadeen
dc.subjectSurveyen
dc.subjectTheoretical Domains frameworken
dc.subject~Pharmacy - Journal Articles~en
dc.titleCommunity pharmacists’ awareness, identification, and management of prescribing cascades: A cross-sectional surveyen
dc.typeArticle (peer-reviewed)en
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