Anjan khadka
Biography
Dr. Anjan Khadka is a general practitioner, academician, and researcher with over a decade of experience in patient care, medical education, and clinical research. He serves as a Hospital Pharmacologist and Research Facilitator at Scheer Memorial Adventist Hospital, Nepal, and has previously worked as an Associate Professor at the Nepalese Army Institute of Health Sciences and Caribbean Medical University. Dr. Khadka has authored over 30 peer-reviewed publications with an h-index of 6 and has expertise in pharmacology, clinical research design, and medical education. He is a member of multiple professional organizations, including the Nepal Medical Association and the Royal Australian College of General Practitioners.
Research Interest
I am still working at Nepalese Army Institute of Health Sciences
Abstract
Prescribing Inertia, Prescribing Cascade and Deprescribing:
Polypharmacy in patients presents significant clinical challenges, with prescribing inertia and prescribing cascades contributing to inappropriate medication use and adverse outcomes. The issue of interconnected phenomena of prescribing inertia, prescribing cascade, and deprescribing strategies in clinical practice needs identification and timely address. Prescribing inertia occurs when clinicians fail to initiate, intensify, or discontinue therapy despite clinical indications. Prescribing cascades develop when adverse drug reactions are misinterpreted as new medical conditions, leading to additional unnecessary medications. Deprescribing represents a systematic approach to medication withdrawal that prioritizes patient safety and quality of life. Effective medication management requires recognition of these prescribing patterns and implementation of structured deprescribing protocols. Healthcare providers must balance therapeutic benefits with potential harms, particularly in vulnerable populations. Successful interventions require interdisciplinary collaboration, patient engagement, and regular medication reviews to optimize therapeutic outcomes while minimizing polypharmacy-related risks.
