Prescribing cascades: do we need this construct? A reply

Paula A Rochon^{1

2

3

4

5}, Denis O'Mahony⁶, Antonio Cherubini^{7

8}, Graziano Onder^{9

10}, Mirko Petrovic¹¹, Kieran Dalton¹², Lisa M McCarthy^{13

14

15}, Shelley A Sternberg¹⁶, Donna R Zwas¹⁷, Nathan M Stall^{18

19

20}, Christina E Reppas-Rindlisbacher^{18

19}, Nathalie van der Velde^{21

22}, Sarah N Hilmer^{23

24}, Wei Wu¹⁸, Joyce Li¹⁸, Amy Ly¹⁸, Jerry H Gurwitz²⁵

Affiliations

¹ Women's Age Lab and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
² ICES, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
³ Department of Medicine, University of Toronto, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
⁴ Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
⁵ Sinai Health System, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
⁶ Department of Medicine (Geriatrics), University College Cork, Cork, Ireland.
⁷ Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy.
⁸ Geriatria, Accettazione Geriatrica e Centro Di Ricerca Per L'invecchiamento, IRCCS INRCA, Ancona, Italy.
⁹ Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
¹⁰ Center of Aging, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.
¹¹ Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
¹² Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
¹³ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
¹⁴ Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada.
¹⁵ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
¹⁶ Division of Geriatrics, Department of Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.
¹⁷ Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
¹⁸ Women's Age Lab and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
¹⁹ Department of Medicine, University of Toronto, Toronto, ON, Canada.
²⁰ Sinai Health System, Toronto, ON, Canada.
²¹ Amsterdam UMC Location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam, The Netherlands.
²² Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
²³ Department of Clinical Pharmacology, Royal North Shore Hospital, Sydney, Australia.
²⁴ Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
²⁵ Division of Geriatric Medicine, UMass Chan Medical School, Worcester, MA, USA.

PMID: 41062874
PMCID: PMC12528249
DOI: 10.1007/s41999-025-01315-8

Prescribing cascades: do we need this construct? A reply

Paula A Rochon et al. Eur Geriatr Med. 2025 Oct.

. 2025 Oct;16(5):1587-1589.

doi: 10.1007/s41999-025-01315-8. Epub 2025 Oct 8.

Authors

Affiliations

¹ Women's Age Lab and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
² ICES, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
³ Department of Medicine, University of Toronto, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
⁴ Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
⁵ Sinai Health System, Toronto, ON, Canada. Paula.rochon@sinaihealth.ca.
⁶ Department of Medicine (Geriatrics), University College Cork, Cork, Ireland.
⁷ Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, Ancona, Italy.
⁸ Geriatria, Accettazione Geriatrica e Centro Di Ricerca Per L'invecchiamento, IRCCS INRCA, Ancona, Italy.
⁹ Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Rome, Italy.
¹⁰ Center of Aging, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.
¹¹ Department of Internal Medicine and Paediatrics, Ghent University, Ghent, Belgium.
¹² Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
¹³ Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
¹⁴ Institute for Better Health, Trillium Health Partners, Toronto, ON, Canada.
¹⁵ Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
¹⁶ Division of Geriatrics, Department of Medicine, Maccabi Healthcare Services, Tel Aviv, Israel.
¹⁷ Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
¹⁸ Women's Age Lab and Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
¹⁹ Department of Medicine, University of Toronto, Toronto, ON, Canada.
²⁰ Sinai Health System, Toronto, ON, Canada.
²¹ Amsterdam UMC Location University of Amsterdam, Internal Medicine, Section of Geriatric Medicine, Amsterdam, The Netherlands.
²² Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
²³ Department of Clinical Pharmacology, Royal North Shore Hospital, Sydney, Australia.
²⁴ Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
²⁵ Division of Geriatric Medicine, UMass Chan Medical School, Worcester, MA, USA.

PMID: 41062874
PMCID: PMC12528249
DOI: 10.1007/s41999-025-01315-8

No abstract available

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: The authors have no competing interest that are directly or indirectly relevant to the content of this study. Ethical approval: The study was approved by the Research Ethics Board of Women’s College Hospital (REB #: 2024-0011-E). Informed consent: The protocol was registered in Open Science Framework ( https://doi.org/10.17605/OSF.IO/7DF62 ).

References

1. Rochon PA, O'Mahony D, Cherubini A, et al. International expert panel's potentially inappropriate prescribing cascades (PIPC) list. Eur Geriatr Med. 2025. - PMC - PubMed
1. O’Mahony D, Rochon PA (2022) Prescribing cascades: we see only what we look for, we look for only what we know. Age Ageing. 10.1093/ageing/afac138 - DOI - PubMed
1. Sternberg SA, Gurwitz JH, Rochon PA. Prescribing Cascades. In: Cherubini A, Mangoni AA, O’Mahony D, Petrovic M, editors., eds. Optimizing pharmacotherapy in older patients : an interdisciplinary approach. Cham: Springer Nature; 2023.
1. Sternberg SA, Guy-Alfandary S, Rochon PA (2021) Prescribing cascades in older adults. CMAJ 193(6):E215 - DOI - PMC - PubMed

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Prescribing cascades: do we need this construct? A reply

Affiliations

Prescribing cascades: do we need this construct? A reply

Authors

Affiliations

Conflict of interest statement

References

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