Wellness Talk with George Batista
Sep 16, 2026 · 10 min · 4 segments
A new large study published in The BMJ on September 10, 2026 examined how one medication can lead to another—sometimes unnecessarily. This is called a “prescribing cascade.” It happens when: A…
George BatistaHost
We all know that medications have side effects, obviously, right? We all know that especially older folks, can be more susceptible to side effects from medications.
We know the term polypharmacy, and that's typically when someone is on four or more medications, which a lot of older folks are, typically like 60, 65 or older, on all these different types of medications.
But what happens when you're not recognizing a side effect from a certain medication? And And it gets mistaken for some other condition.
And it looked at how one medication can lead to another, sometimes unnecessarily.
the side effect is mistaken for a new medical condition, a second medication is prescribed to treat that condition, and then that medication may also introduce additional risks or side effects.
So that's the prescribing cascade, which is very, very interesting, right? So for example, if we take a look at NSAIDs, right, or non-steroidal anti-inflammatories, typically prescribed for pain, And so it's commonly known that those anti-inflammatories, the risk of that or the common side effect of that is a raising of blood pressure.
So what happens is let's say your blood pressure gets raised after you're on an NSAID.
And instead of reconsidering that NSAID, the physician may just place you on a blood pressure medication.
So now you're not only on the NSAID, but you're on the blood pressure medication.
And what they found was there were 24 high priority cascades that were relatively common and potentially harmful, specifically in older people.
Now, they did this study in geriatric folks, right? Again, people that are 60, 65 or older that tend to be more susceptible to these cascades, more susceptible to all different types of side effects from medications.
So, and they also looked at women, older women who tend to be more susceptible to this as well, which is very interesting.
We all know that medications have side effects, obviously, right? We all know that especially older folks, can be more susceptible to side effects from medications.
We know the term polypharmacy, and that's typically when someone is on four or more medications, which a lot of older folks are, typically like 60, 65 or older, on all these different types of medications.
But what happens when you're not recognizing a side effect from a certain medication? And And it gets mistaken for some other condition.
And it looked at how one medication can lead to another, sometimes unnecessarily.
the side effect is mistaken for a new medical condition, a second medication is prescribed to treat that condition, and then that medication may also introduce additional risks or side effects.
So that's the prescribing cascade, which is very, very interesting, right? So for example, if we take a look at NSAIDs, right, or non-steroidal anti-inflammatories, typically prescribed for pain, And so it's commonly known that those anti-inflammatories, the risk of that or the common side effect of that is a raising of blood pressure.
So what happens is let's say your blood pressure gets raised after you're on an NSAID.
And instead of reconsidering that NSAID, the physician may just place you on a blood pressure medication.
So now you're not only on the NSAID, but you're on the blood pressure medication.
And what they found was there were 24 high priority cascades that were relatively common and potentially harmful, specifically in older people.
Now, they did this study in geriatric folks, right? Again, people that are 60, 65 or older that tend to be more susceptible to these cascades, more susceptible to all different types of side effects from medications.
So, and they also looked at women, older women who tend to be more susceptible to this as well, which is very interesting.
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