Can Simulation Prevent Prescribing Cascades? A Pilot Study

Prescribing cascades occur when an adverse drug reaction (ADR) is not recognized, and a second medication is prescribed to treat the ADR. Thirty-two family nurse practitioner students were included in this study. Students self-selected 1 of 2 days for a simulation experience. A coin toss determined the experimental group (day 1) and the control group (day 2). The experimental group scenario involved an ADR, whereas the control group scenario did not. Four months later, all students participated in a different ADR scenario. After the history and physical portions, students submitted their differential diagnosis to the facilitator. There was no difference in ADR recognition between the experimental and control groups. •To prevent prescribing cascades, adverse drug reactions (ADRs) must first be recognized.•This study examined the recognition of ADRs 4 months after a simulated ADR scenario.•Nurse practitioner simulation research must examine long-term changes in behavior.•No difference was found between the experimental and control groups.