Medication Use & Patient Safety
“Our work gives patients and providers evidence about the outcomes of medication use — both harmful and beneficial — to help them make informed personal decisions about prescription drug use.”
Sascha Dublin, MD, PhD
Kaiser Permanente Washington Health Research Institute Senior Investigator
Physician, Washington Permanente Medical Group, Internal Medicine
Research overview
Americans are using more prescription drugs than ever. Consequently, they’re coping with more side effects, drug interactions, and costs, especially if they’re using multiple medications. Kaiser Permanente Washington Health Research Institute (KPWHRI) scientists are on the forefront of answering questions about these concerns. We’re studying the beneficial and harmful effects of medications in real-world settings, and innovating better ways to manage and monitor drug use.
The institute contributes to national initiatives to monitor medication safety as well as providing information to help doctors and patients weigh the risks and benefits of various prescription drugs.
Funders of KPWHRI medication use and patient safety research include the Centers for Disease Control and Prevention, the U.S. Food and Drug Administration, the National Institutes of Health, the Patient-Centered Outcomes Research Institute, and other sources. A few projects include:
- Studying whether commonly used medications, including oral contraceptives, are associated with the risk of developing COVID-19 infection or severe disease
- Exploring patient and clinical risk factors for opioid misuse, abuse, and addiction
- Evaluating an intervention for patients taking long-term high-dose opioids to successfully taper their use without negatively impacting pain management and quality of life
- Proactive monitoring of medical products through the FDA Sentinel Initiative
- Studying medication safety for pregnant people and older adults
- Monitoring vaccine safety and effectiveness
- Investigating how medications affect risk of cognitive decline and dementia in late life
- Reaching out to inform patients and providers about the risks of, and alternatives to, commonly used medications that may contribute to falls, including over-the-counter antihistamines
Recent publications on Medication Use & Patient Safety
Carrell DS, Cronkite DJ, Shea M, Oliver M, Luce C, Matson TE, Bobb JF, Hsu C, Binswanger IA, Browne KC, Saxon AJ, McCormack J, Jelstrom E, Ghitza UE, Campbell CI, Bradley KA, Lapham GT. Clinical documentation of patient-reported medical cannabis use in primary care: toward scalable extraction using natural language processing methods. Subst Abus. 2022;43(1):917-924. doi: 10.1080/08897077.2021.1986767. PubMed
Hart LA, Walker R, Phelan EA, Marcum ZA, Schwartz NRM, Crane PK, Larson EB, Gray SL. Change in central nervous system-active medication use following fall-related injury in older adults. J Am Geriatr Soc. 2021 Oct 19. doi: 10.1111/jgs.17508. Online ahead of print. PubMed
Gold LS, Marcum ZA, Meier EN, Turner JA, James KT, Kallmes DF, Leutmer PH, Griffith B, Sherman KJ, Friedly JL, Suri P, Deyo RA, Johnson SK, Avins AL, Heagerty PJ, Jarvik JG. Patient, provider, and clinic characteristics associated with opioid and non-opioid pain medication prescriptions for patients receiving low back imaging in primary care. J Am Board Fam Med. 2021 Sep-Oct;34(5):950-963. doi: 10.3122/jabfm.2021.05.210033. PubMed
Marcum ZA, Gold LS, James KT, Meier EN, Turner JA, Kallmes DF, Cherkin DC, Deyo RA, Sherman KJ, Luetmer PH, Avins AL, Griffith B, Friedly JL, Suri P, Heagerty PJ, Jarvik JG. Effects of including epidemiologic data in lumbar spine imaging reports on prescribing non-opioid medications for pain. J Gen Intern Med. 2021 Aug;36(8):2237-2243. doi: 10.1007/s11606-021-06627-6. Epub 2021 Feb 8. PubMed
Pocobelli G, Dublin S, Bobb JF, Albertson-Junkans L, Andrade S, Cheetham TC, Salgado G, Griffin MR, Raebel MA, Smith D, Li DK, Pawloski PA, Toh S, Taylor L, Hua W, Horn P, Trinidad JP, Boudreau DM. Prevalence of prescription opioid use during pregnancy in eight US health plans during 2001-2014. Pharmacoepidemiol Drug Saf. 2021 Nov;30(11):1541-1550. doi: 10.1002/pds.5312. Epub 2021 Jul 7. PubMed
Researchers in Medication Use & Patient Safety
 Sascha Dublin, MD, PhDSenior Investigator |
 Jessica Chubak, PhDSenior Investigator |
 Andrea J. Cook, PhDSenior Biostatistics Investigator |
 Rita Mangione-Smith, MD, MPHExecutive Director and Senior Investigator, KPWHRI; Vice President for Research and Health Care Innovation, Kaiser Permanente Washington |
 Eric B. Larson, MD, MPH, MACPSenior Investigator and former Executive Director, KPWHRI; Former Vice President for Research and Health Care Innovation, KPWA |
 Jennifer C. Nelson, PhDDirector, Biostatistics; Senior Investigator |
 David E. Arterburn, MD, MPHSenior Investigator |
 Susan M. Shortreed, PhDSenior Biostatistics Investigator |
 Lisa A. Jackson, MD, MPHSenior Investigator |
 Karen Wernli, PhDAssociate Investigator |
 Onchee Yu, MSSenior Collaborative Biostatistician |
 Rod L. Walker, MSSenior Collaborative Biostatistician |
 Robert D. Wellman, MSSenior Collaborative Biostatistician |
 Gaia Pocobelli, PhDCollaborative Scientist |
 David S. Carrell, PhDAssociate Investigator |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Jennifer F. Bobb, PhDAssociate Biostatistics Investigator |
 Weiwei Zhu, MSSenior Collaborative Biostatistician |
 Paige D. Wartko, PhD, MPHCollaborative Scientist |
 Maricela Cruz, PhDAssistant Biostatistics Investigator |
 Brian D. Williamson, PhDAssistant Biostatistics Investigator |
 Noorie Hyun, PhDAssistant Biostatistics Investigator |
 Laurel Hansell, MA, MPHCollaborative Scientist |
 Jess Mogk, MPHCollaborative Scientist |
Affiliate researchers
Susan Heckbert, MD, PhD
University of Washington (UW) Department of Epidemiology; UW Cardiovascular Health Research Unit
David Siscovick, MD, MPH
UW Department of Medicine; UW Department of Epidemiology; UW Cardiovascular Health Research Unit
Leslie Spangler, PhD
Amgen
Research
IUD perforation: Rare but important to know about
New study results in more precise language in the federally mandated warning about this possibility.
Research
New findings on treating hypertension in pregnancy
A study led by Dr. Sascha Dublin finds similar outcomes for 3 hypertension medications, filling an evidence gap.
COVID-19 treatments
New report supports value of COVID-19 drugs
A team led by KPWHRI's Kai Yeung, PharmD, PhD, reviewed trial results for cost-effectiveness of 3 treatments.
Prescription overload
Deprescribing: Less may be more
Dr. Sascha Dublin explains why sometimes not taking medications may be a safer and healthier choice.
Electronic health records
EHR study offers insights on medical cannabis use
New research examines providers’ notes to understand patients’ cannabis use and health conditions.
Research
HEAL responds to double crisis: Opioids and COVID-19
Health care is increasingly online—KPWHRI is studying telehealth options for opioid use disorder and chronic pain.
research
Medication in pregnancy: Better data for healthier kids
Researchers need much bigger data sets to find outcomes that matter, Dr. Sascha Dublin and colleagues write in Pediatrics.
profile
What inspires Sascha Dublin’s maternal health research?
Evidence from Dr. Dublin’s work helps patients and doctors make the best care choices in pregnancy.
drug safety
FDA to expand drug-safety monitoring capacity
New funding will establish an innovation center, to be led by Harvard Pilgrim in partnership with KPWHRI and others.
medication safety
Using phentermine for weight loss longer term found to be safe, effective
Dr. David Arterburn discusses reassuring news from his PCORnet study of the most widely used anti-obesity drug in the United States.
aging & geriatrics
Do drugs cause falls for adults with dementia?
Researchers find a relationship between prescribed central nervous system-active medications and increased risk of falling among older people with dementia.
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