The incidence of a specific type of “prescribing cascade” among patients with Alzheimer disease is low, according to a new analysis of data from the NIH Collaboratory Distributed Research Network (DRN). The study was published in the Journal of the American Geriatrics Society.

Persons with Alzheimer disease are at high risk for prescribing cascades, in which patients receive potentially unnecessary drug prescriptions to address side effects of their other medications. Although prescribing cascades involving antidopaminergic and antiparkinsonian medications in particular have been identified as a high-priority target for improving medication safety in patients with Alzheimer disease, little is known about their incidence in this population.

Investigators from the Controlling and Stopping Cascades Leading to Adverse Drug Effects Study in Alzheimer’s Disease (CASCADES‐AD) used administrative claims data from 2 large commercial health insurance providers to address this gap in knowledge. The providers are data partners in the NIH Collaboratory DRN. Using data for more than 121,000 patients with Alzheimer disease, the researchers found that the proportion of antidopaminergic-antiparkinsonian medication prescribing cascades was low. Only 36 patients received an antiparkinsonian medication out of more than 4500 patients who were taking an antipsychotic drug or metoclopramide.

CASCADES-AD was supported by a grant from the National Institute on Aging. Read more about the NIH Collaboratory DRN.