TY - JOUR
T1 - Prescription Sequence Symmetry Analysis (PSSA) to assess prescribing cascades
T2 - a step-by-step guide
AU - Hendrix, Mandy R. S.
AU - Yasar, Mustafa
AU - Mohammad, Atiya K.
AU - Hugtenburg, Jacqueline G.
AU - Vanhommerig, Joost W.
AU - Gündoğan-Yilmaz, Ruveyda
AU - van den Bemt, Patricia M. L. A.
AU - Denig, Petra
AU - Karapinar-Carkıt, Fatma
N1 - Funding Information: We would like to thank Marinda Spies (NCONTROL) for the data extraction. We would also like to thank Annemariek Driessen (MUMC) for validating the SPSS syntax. Publisher Copyright: © 2024, The Author(s).
PY - 2024/12/1
Y1 - 2024/12/1
N2 - 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.
AB - 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.
KW - Pharmacoepidemiology
KW - Pharmacovigilance
KW - Prescribing cascade
KW - Sequence symmetry analysis
KW - Signal detection
UR - http://www.scopus.com/inward/record.url?scp=85181943720&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12874-023-02108-y
DO - https://doi.org/10.1186/s12874-023-02108-y
M3 - Article
C2 - 38212730
SN - 1471-2288
VL - 24
JO - BMC medical research methodology
JF - BMC medical research methodology
IS - 1
M1 - 8
ER -