Katharine Bradley, MD, MPH

"Our research develops ways that medical providers and systems can help people avoid harm due to unhealthy alcohol and drug use—from prevention to treatment."

Katharine A. Bradley, MD, MPH 

Senior Investigator, Kaiser Permanente Washington Health Research Institute
Physician, Washington Permanente Medical Group, Internal Medicine

Biography

Kathy Bradley, MD, MPH, is a senior investigator and general internist whose research focuses on identifying and addressing unhealthy alcohol use in primary care. Since joining Kaiser Permanente Washington Health Research Institute (KPWHRI) in 2011, Dr. Bradley has conducted research that is having a lasting impact on how patients with alcohol use disorders are cared for at Kaiser Permanente Washington and beyond.

While at the Veterans Affairs (VA) Puget Sound Health Care System, Dr. Bradley discovered ways to more efficiently identify unhealthy alcohol use. Her team validated the “AUDIT-C” three-item alcohol screen and a single-question screen in VA patients as well as non-VA patient populations. They also linked high AUDIT-C scores with adverse health outcomes, including decreased medication adherence and increases in fractures and trauma; hospitalizations for liver disease, gastrointestinal bleeding and pancreatitis; surgical complications and post-op health care utilization; and mortality. An ongoing VA study is evaluating whether changes in AUDIT-C scores are associated with changes in health outcomes. If so, AUDIT-C scores could be used as a “vital sign” to monitor drinking.

Dr. Bradley was instrumental in helping implement alcohol screening and brief alcohol counseling at more than 900 VA sites—and in developing the VA's national performance measures. Using performance measures and decision support in an electronic health record (EHR), yearly alcohol screening rates in the VA have been high since 2007. Her team also developed and tested an EHR-based clinical reminder that provides decision support for brief alcohol counseling, as well as performance measures for counseling. Together, the EHR tools and the performance measures recently resulted in high rates of alcohol counseling.

Currently, Dr. Bradley is evaluating performance measures of brief alcohol counseling. She recently turned her attention to management of alcohol use disorders in primary care settings, as well as identifying and addressing drug use disorders with proactive outreach. She is leading the National Institute of Health's National Institute on Alcohol Abuse and Alcoholism Study on Collaborative Care for Primary Care Patients with unhealthy drinking: "Considering Healthier Drinking Options in Collaborative Care" (CHOICE) trial, which has finished enrollment and will be completed in October 2015. She and her clinical partners are also funded by the Agency for Health Research and Quality to implement alcohol screening, brief alcohol counseling, and shared decision-making for alcohol use disorders in a sustainable manner at all 25 primary care clinics within Kaiser Permanente Washington. In addition, she has ongoing research developing a patient decision aid for shared decision-making for alcohol use disorders, and with her clinical partners, has obtained a Partnership for Innovation grant to test proactive outreach from primary care teams to patients with alcohol or drug use disorders. 

Dr. Bradley is an affiliate professor in the University of Washington departments of Medicine and Health Services.

RESEARCH INTERESTS AND EXPERIENCE

 

Recent publications

Williams EC, Bryson CL, Sun H, Au DH, Bradley KA. Association between alcohol use and angina symptoms among outpatients from the Veterans Health Administration. J Addict Med. 2018 Jan 12. doi: 10.1097/ADM.0000000000000379. [Epub ahead of print]. PubMed

Lapham GT, Lee AK, Caldeiro RM, McCarty D, Browne KC, Walker DD, Kivlahan DR, Bradley KA. Frequency of cannabis use among primary care patients in Washington state. J Am Board Fam Med. 2017 Nov-Dec;30(6):795-805. doi: 10.3122/jabfm.2017.06.170062. PubMed

Williams EC, Achtmeyer CE, Young JP, Berger D, Curran G, Bradley KA, Richards J, Siegel MB, Ludman EJ, Lapham GT, Forehand M, Harris AHS. Barriers to and facilitators of alcohol use disorder pharmacotherapy in primary care: a qualitative study in five VA clinics. J Gen Intern Med. 2017 Oct 30. doi: 10.1007/s11606-017-4202-z. [Epub ahead of print]. PubMed

Berger D, Lapham GT, Shortreed SM, Hawkins EJ, Rubinsky AD, Williams EC, Achtmeyer CE, Kivlahan DR, Bradley KA. Increased rates of documented alcohol counseling in primary care: more counseling or just more documentation? J Gen Intern Med. 2017 Oct 18. doi: 10.1007/s11606-017-4163-2. [Epub ahead of print]. PubMed

 

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