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 unhealthy alcohol use 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. She also demonstrated that changes in AUDIT-C scores are associated with changes in health outcomes, suggesting that AUDIT-C scores might be useful as a “vital sign” to monitor drinking over time.

Dr. Bradley was instrumental in helping implement alcohol screening and brief alcohol counseling at more than 900 VA sites using performance measures and decision support in the VA's electronic health record (EHR). 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 resulted in high rates of alcohol counseling.

Dr. Bradley recently turned her attention to management of alcohol use disorders in primary care settings. She led the National Institute of Health's National Institute on Alcohol Abuse and Alcoholism (NIAAA) study on collaborative care for primary care patients with unhealthy drinking: "Considering Healthier Drinking Options in Collaborative Care" (CHOICE) trial, which demonstrated that the CHOICE model of nurse care management increased the proportion of patients who took medications for alcohol use disorders, but did not improve drinking outcomes. She was also funded by the Agency for Health Research and Quality to conduct the Sustained Patient-centered Alcohol-related Care (SPARC) trial across all 25 primary care clinics within Kaiser Permanente Washington. SPARC tested state-of-the-art strategies for implementing alcohol screening, brief alcohol counseling, and shared decision-making for alcohol use disorder; analyses are in progress. In addition, her team recently developed 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. 

Since 2015, Dr. Bradley has been a multiple principal investigator of the Health Systems Node of the National Institute on Drug Abuse Clinical Trials Network (CTN), along with Drs. Connie Weisner and Cynthia Campbell at Northern California Kaiser Permanente. Dr. Bradley currently leads the CTN Primary care Opioid Use Disorders (PROUD) trial, a pragmatic implementation trial of the Massachusetts Model of Office Based Addiction Treatment (OBAT) for opioid use disorder in primary care across six diverse health systems in Texas, Florida, Michigan, New York, and Washington state. She also co-leads with Gwen Lapham, PhD, a study using EHR data to study medical marijuana.  Dr. Bradley is also supported half time by NIAAA to mentor early-career clinician researchers interested in improving care for unhealthy alcohol use. 

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, McGinnis KA, Tate JP, Matson TE, Rubinsky AD, Bobb JF, Lapham GT, Edelman EJ, Catz SL, Satre DD, Bryant KJ, Marshall BDL, Kraemer KL, Bensley KM, Richards JE, Skanderson M, Justice AC, Fiellin DA, Bradley KA. HIV disease severity is sensitive to temporal changes in alcohol use: a national study of VA patients with HIV. J Acquir Immune Defic Syndr. 2019 Apr 6. doi: 10.1097/QAI.0000000000002049. [Epub ahead of print]. PubMed

Freeman PR, Curran GM, Drummond KL, Martin BC, Teeter BS, Bradley K, Schoenberg N, Edlund MJ. Utilization of prescription drug monitoring programs for prescribing and dispensing decisions: results from a multi-site qualitative study. Res Social Adm Pharm. 2018 Sep 14. pii: S1551-7411(18)30303-6. doi: 10.1016/j.sapharm.2018.09.007. [Epub ahead of print]. PubMed

Curran GM, Freeman PR, Martin BC, Teeter BS, Drummond KL, Bradley K, Thannisch MM, Mosley CL, Schoenberg N, Edlund M. Communication between pharmacists and primary care physicians in the midst of a U.S. opioid crisis. Res Social Adm Pharm. 2018 Aug 10. pii: S1551-7411(18)30302-4. doi: 10.1016/j.sapharm.2018.08.006. [Epub ahead of print]. PubMed

Glass JE, Bobb JF, Lee AK, Richards JE, Lapham GT, Ludman E, Achtmeyer C, Caldeiro RM, Parrish R, Williams EC, Lozano P, Bradley KA. Study protocol: a cluster-randomized trial implementing Sustained Patient-centered Alcohol-related Care (SPARC trial). Implement Sci. 2018;13(1):108. doi: 10.1186/s13012-018-0795-9. PubMed

 

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