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[Comment] The prescribing cascade revisited

A prescribing cascade begins when a drug is prescribed, an adverse drug event occurs that is misinterpreted as a new medical condition, and a subsequent drug is prescribed to treat this drug-induced adverse event (figure). We first described the idea of a prescribing cascade in The Lancet in 1995,1 and expanded on this concept in The BMJ in 1997.2 The identification and interruption of prescribing cascades is an important, actionable, and underappreciated opportunity to improve medication safety in older people.