The information provided in this blog post is for general informational purposes only and is not intended as medical, financial, or insurance advice. Healthcare needs and financial situations vary from person to person. Decisions about your medical care should be made in consultation with your primary care provider. Insurance and financial decisions should be made with a licensed insurance or financial professional. This content does not establish a provider-patient relationship, and reliance on any information provided herein is solely at your own risk.
From Saturday mornings at the Carmel Farmers Market to evening walks through the Arts & Design District, our community values a life of vitality. But for many in Central Indiana, that vitality is masked by a growing list of prescriptions.
If you feel like you are taking a pill to treat the side effects of another pill, you may be caught in what is known as a prescribing cascade.
What is a Prescribing Cascade?
A prescribing cascade occurs when a medication side effect is misdiagnosed as a new medical condition, leading to further prescriptions to treat the side effect. This has been identified as a primary contributor to polypharmacy, or the use of multiple medications that can sometimes be avoided by addressing the root cause of an illness rather than just its symptoms (1). In addition to the elevated cost of keeping up with multiple medications, there is an increased risk of non-adherence to a medication plan, medication errors and a reduced quality of life among other negative outcomes (1).
In our traditional, fast-paced corporate clinics in Hamilton County, primary care providers can sometimes lack the time to investigate if your new symptom is actually a side effect that could be addressed differently than with an additional prescription.
The ACLM Solution: The 6 Pillars of Health
As a direct primary care (DPC), our nurse practitioners approach the prescription pad with a Lifestyle-first mentality. We use the ACLM’s evidence-based framework to stop the cascade when possible. We focus on the 6 Pillars of Lifestyle Medicine to treat, and even reverse, chronic diseases (2). They include: Whole-food, plant-predominant eating, Physical activity, Restorative sleep, Stress management, Seeking out positive social connections and finally, Avoidance of risky substances.
By optimizing these pillars, we create an environment where the body can heal, potentially making long-term medications for certain chronic conditions unnecessary.
Personalized Care with Farah and Keyla
Our DPC offers a level of accessibility and thoroughness that busy Carmel professionals, whose schedules are often beholden to client needs, truly appreciate.
Farah Myers, FNP, DipACLM: As a Diplomate of the American College of Lifestyle Medicine, Farah is specialized in the therapeutic use of lifestyle interventions to reduce medication dependency.
Keyla Matthews, FNP: Keyla brings a holistic, patient-centered approach to family health, ensuring that every treatment plan is as unique as the patient.
The Power of Deprescribing
Our nurse practitioners have the time to sit with you for 30–60 minutes, which allows us to focus on deprescribing, the clinical process of supervised medication reduction. The ACLM highlights that for many chronic conditions, like Type 2 Diabetes or hypertension, lifestyle changes are the answer to polypharmacy, allowing patients to safely reduce their medication load under expert guidance (3).
Why DPC is the Choice for Central Indiana Professionals
If you live near the White River or work in the Northside professional corridor, you know how hard it is to find a primary care provider who fits your schedule. Our DPC model offers: Same-day or next-day appointments, Direct access to your NP via text or email and Schedule Flexibility. If your client meeting runs long, we make it easy to reschedule without waiting months for a new opening.
Ready to simplify your health and break the medication cascade? Schedule a meet and greet with us to learn more about our Direct Primary Care memberships and see how Farah and Keyla can help you reclaim your vitality.
Sources & References:
Ige OA, Akpa OM. Polypharmacy, Unintended Consequences, and the Impact of Lifestyle Medicine. American Journal of Lifestyle Medicine. 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC11339771/
American College of Lifestyle Medicine. What is Lifestyle Medicine? (The 6 Pillars).https://lifestylemedicine.org/about-lifestyle-medicine/
American College of Lifestyle Medicine. Medication Deprescribing Resources.https://lifestylemedicine.org/medication-deprescribing/
Frequently Asked Questions about Medication Cascades & DPC
1. What exactly is a “prescribing cascade”?
A prescribing cascade occurs when a medication side effect is misinterpreted as a brand-new medical condition. This often leads to a second prescription to “treat” the side effect of the first (1). At our Carmel direct primary care, our Family Nurse Practitioners spend more time with you, helping to identify these cycles and stop them at the root cause.
2. How does Lifestyle Medicine help with deprescribing?
Lifestyle Medicine focuses on the “6 Pillars of Health”, including nutrition and stress management, to treat the underlying causes of chronic illness (2). By improving these areas, many patients find they can safely reduce or eliminate certain medications under the supervision of a primary are provider, a process known as deprescribing.
3. Why is Direct Primary Care (DPC) better for busy professionals in Carmel?
Busy professionals in Central Indiana often have schedules beholden to client needs. Our DPC model offers maximum flexibility with same-day or next-day appointments and direct text/email access to Farah Myers, FNP and DipACLM or Keyla Matthews, FNP. Unlike traditional clinics, you won’t wait months to get back on the schedule if you need to move an appointment.
4. Are Nurse Practitioners (NPs) able to manage my medications and deprescribing goals?
Yes. As Family Nurse Practitioners, Farah and Keyla are fully licensed to manage your prescriptions. Our practice approach is “Lifestyle-First,” meaning we use prescriptions thoughtfully and personally while prioritizing evidence-based lifestyle interventions to simplify your health regimen whenever possible.
