Gwen Lapham, PhD, MPH

"My colleagues and I are working on ways to ensure that people who are at risk for unhealthy alcohol use receive the most effective care that is right for them."

Gwen Lapham, PhD, MPH, MSW

Research Associate, Kaiser Permanente Washington Health Research Institute

Areas of focus:

Biography

Screening patients for high-risk behaviors such as unhealthy alcohol use is a foundation of good preventive care. But how often and in what form does such screening work best? KPWHRI Research Associate Gwen Lapham, PhD, MPH, MSW, is on a mission to find out.

Dr. Lapham joined the Institute in 2013 after six years as the senior project director and data analyst for the Alcohol Misuse Workgroup at the Veterans Affairs (VA) Puget Sound Health Care System, Department of Health Services Research & Development. Working with her longtime VA mentor Katherine Bradley, MD, MPH, now a KPWHRI senior investigator, Dr. Lapham is shedding  light on practical strategies to make screening for alcohol misuse more  efficient and effective.

Most patients screen negative for unhealthy alcohol use during  in-person assessments—and until recently, little was known about the optimal  intervals and methods for repeat screening of these patients. But by delving  into the VA’s rich data on routine alcohol screening, Dr. Lapham and colleagues  are starting to identify the sweet spot—the point at which the value gained from repeat screening outweighs the resources necessary to conduct screening and follow-up on positive screens. Publishing in Medical Care in October 2013, they found that extending the screening interval was appropriate for certain low-risk veterans.

Previously, Dr. Lapham demonstrated that the VA’s effort to implement brief interventions for unhealthy alcohol use in more than 900 clinics nationwide led to increases in provider-documented brief interventions. She also found that recently returned Veterans need information on the importance of recommended drinking limits and may be more willing to honestly report their alcohol use when it’s not documented in their medical record.

Moving forward, Dr. Lapham is pursuing work to implement evidence-based and patient-centered care for unhealthy alcohol use in other settings. A recipient of the University of Washington (UW) School of Public Health 2012 Outstanding Graduate Student Award, she currently serves as a member of the Research Society on Alcoholism and is part of the UW’s Health Services Professional Development Group.     

 

RESEARCH INTERESTS AND EXPERIENCE

 

 

Recent publications

Bradley KA, Bobb JF, Ludman EJ, Chavez LJ, Saxon AJ, Merrill JO, Williams EC, Hawkins EJ, Caldeiro RM, Achtmeyer CE, Greenberg DM, Lapham GT, Richards JE, Lee AK, Kivlahan DR. Alcohol-related nurse care management in primary care: a randomized clinical trial. JAMA Intern Med. 2018 Mar 26. pii: 2674869. doi: 10.1001/jamainternmed.2018.0388. [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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