Prescription Sequence Symmetry Analysis (PSSA) to assess prescribing cascades: a step-by-step guide

Prescribing cascades occur when patients are prescribed medication to treat the adverse drug reaction of previously prescribed medication. Prescription sequence symmetry analysis (PSSA) can be used to assess the association between two medications in prescription or dispensing databases and thus the...

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Bibliographic Details
Published in:BMC medical research methodology 2024-01, Vol.24 (1), p.8-8, Article 8
Main Authors: Hendrix, Mandy R S, Yasar, Mustafa, Mohammad, Atiya K, Hugtenburg, Jacqueline G, Vanhommerig, Joost W, Gündoğan-Yilmaz, Ruveyda, van den Bemt, Patricia M L A, Denig, Petra, Karapinar-Carkıt, Fatma
Format: Article
Language:English
Subjects:
Adverse and side effects
Adverse Drug Reaction Reporting Systems
Asymmetry
Data collection
Data entry
Databases, Factual
Diuretics
Drug-Related Side Effects and Adverse Reactions
Drugs
Edema
Evaluation
Humans
Hypothyroidism
Patients
Pharmacoepidemiology
Pharmacovigilance
Pharmacy
Polypharmacy
Prescribing cascade
Prescription writing
Prescriptions
Sequence symmetry analysis
Signal detection
Symmetry
Trends
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Summary:Prescribing cascades occur when patients are prescribed medication to treat the adverse drug reaction of previously prescribed medication. Prescription sequence symmetry analysis (PSSA) can be used to assess the association between two medications in prescription or dispensing databases and thus the potential occurrence of prescribing cascades. In this article, a step-by-step guide is presented for conducting PSSA to assess prescribing cascades. We describe considerations for medication data collection and setting time periods for relevant parameters, including washout window, exposure window, continued exposure interval and blackout period. With two examples, we illustrate the impact of changes in these parameters on the strengths of associations observed. Given the impact seen, we recommend that researchers clearly specify and explain all considerations regarding medication included and time windows set when studying prescribing cascades with PSSA, and conduct subgroup and sensitivity analyses.
ISSN:1471-2288
1471-2288
DOI:10.1186/s12874-023-02108-y