241 STOPPCASCADE: DEVELOPMENT OF A NOVEL EXPLICIT SCREENING TOOL FOR POTENTIALLY CLINICALLY RELEVANT PRESCRIBING CASCADES IN OLDER ADULTS

Abstract Background Prescribing cascades represent an important, often underrecognized, element of problematic polypharmacy. Cascades occur when Adverse Drug Event (ADE) is misinterpreted as a new medical condition, with the subsequent prescription another, potentially inappropriate drug. Our objective was to develop and validate explicit list clinically relevant prescribing in older adults facilitate detection more common important assist clinicians medication review. Methods A structured literature search PubMed, Cinahl Google Scholar undertaken. Search terms included OR Cascade AND Older Adults Over 65 People Gero* Geri*. We aged ≥65 including studies all settings i.e. community, hospital residential care. study designs reviews, experimental observational studies, case series reports. also published abstracts from scientific meetings search. Studies that didn’t include abstract, no access full text article or English version exclusively describing patients ≤65 were excluded. physiological systems-based short-list compiled Anatomical Therapeutic Chemical codes identifying initial prescribed drug (Drug A). Three assessment panellists (academic geriatricians) asked evaluate each individual cascade accompanying evidence using 5-point Likert scale for inclusion/exclusion list. Potential scored 4 5 by 2 3 final Results 131 potential reviewed panel, 71 accepted, involving 41 drugs/drug classes. Conclusion The STOPPCascade comprises adults. This novel designed identify appropriate deprescribing.