Medication Use & Patient Safety
“Our research aims to improve patient outcomes by providing evidence on the risks and benefits of pharmaceuticals, as well as informing best prescribing practices.”
Denise M. Boudreau, RPh, PhD
Kaiser Permanente Washington Health Research Institute Senior Investigator
Research overview
Americans are using more prescription drugs than ever. Consequently, they’re worrying about side effects, drug interactions, and cost, 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.
“We can dramatically improve health care by making sure people get the right medicines at appropriate doses,” said Denise Boudreau, PhD, KPWHRI senior investigator. “The institute contributes to this effort by participating in national initiatives to monitor medication safety. At the personal level, we’re providing information to doctors and patients for weighing 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 (FDA), the National Institutes of Health, the Patient-Centered Outcomes Research Institute, and other sources. A few projects include:
- 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 by 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; and
- engaging in quality improvement efforts to reduce medication-related falls in older people.
“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,” said senior investigator Sascha Dublin, MD, PhD.
Recent publications on Medication Use & Patient Safety
Martin D, Gagne JJ, Gruber S, Izem R, Nelson JC, Nguyen MD, Ouellet-Hellstrom R, Schneeweiss S, Toh S, Walker AM. Sequential surveillance for drug safety in a regulatory environment. Pharmacoepidemiol Drug Saf. 2018 Jul;27(7):707-712. doi: 10.1002/pds.4407. Epub 2018 Mar 5. No abstract available. PubMed
Thakral M, Walker RL, Saunders K, Shortreed SM, Dublin S, Parchman M, Hansen RN, Ludman E, Sherman KJ, Von Korff M. Impact of opioid dose reduction initiatives on chronic opioid therapy patients at higher risk for opioid-related adverse outcomes. Pain Med. 2017 Dec 6. doi: 10.1093/pm/pnx293. [Epub ahead of print]. PubMed
Gray SL, Walker RL, Dublin S, Yu O, Bowles EJA, Anderson ML, Crane PK, Larson EB. Proton pump inhibitor use and dementia risk: prospective population-based study. J Am Geriatr Soc. 2017 Nov 14. doi: 10.1111/jgs.15073. [Epub ahead of print]. PubMed
Simon GE, Johnson E, Stewart C, Rossom RC, Beck A, Coleman KJ, Waitzfelder B, Penfold R, Operskalski BH, Shortreed SM. Does patient adherence to antidepressant medication actually vary between physicians? J Clin Psychiatry. 2018 May/Jun;79(3). pii: 16m11324. doi: 10.4088/JCP.16m11324. PubMed
Chen L, Chubak J, Boudreau DM, Barlow WE, Weiss NS, Li CI. Use of antihypertensive medications and risk of adverse breast cancer outcomes in a SEER-Medicare population. Cancer Epidemiol Biomarkers Prev. 2017 Nov;26(11):1603-1610. doi: 10.1158/1055-9965.EPI-17-0346. Epub 2017 Aug 14. PubMed
Researchers in Medication Use & Patient Safety
 Denise M. Boudreau, PhDSenior Investigator |
 Sascha Dublin, MD, PhDSenior Investigator |
 Jessica Chubak, PhD, MBHLSenior Investigator |
 Andrea J. Cook, PhDSenior Investigator |
 Michael L. Jackson, PhD, MPHAssociate Investigator |
 Rita Mangione-Smith, MD, MPHVice President for Research and Health Care Innovation, Kaiser Permanente Washington; Executive Director and Senior Investigator, Kaiser Permanente Washington Health Research Institute |
 Eric B. Larson, MD, MPH, MACPSenior Investigator and former Executive Director, Kaiser Permanente Washington Health Research Institute; Former Vice President for Research and Health Care Innovation, Kaiser Permanente Washington |
 Diana L. Miglioretti, PhDSenior Investigator, KPWHRI; Dean’s Professor of Biostatistics, University of California, Davis |
 Jennifer C. Nelson, PhDDirector of Biostatistics; Senior Investigator |
 Bruce M. Psaty, MD, PhDSenior Investigator, KPWHRI; Professor of Medicine, Epidemiology, and Health Services, University of Washington |
 David E. Arterburn, MD, MPHSenior Investigator, KPWHRI; Physician, Washington Permanente Medical Group, Internal Medicine |
 Susan M. Shortreed, PhDSenior Investigator |
 Lisa A. Jackson, MD, MPHSenior Investigator |
 Karen Wernli, PhDAssociate Investigator |
 Onchee Yu, MSSenior Biostatistician |
 Rod L. Walker, MSBiostatistician |
 Robert D. Wellman, MSBiostatistician |
 Gaia Pocobelli, PhDResearch Associate |
 David S. Carrell, PhDAssistant Investigator |
 Lu Chen, PhD, MPHAssistant Investigator |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Jennifer F. Bobb, PhDAssistant Investigator |
 Weiwei Zhu, MSBiostatistician III |
 Paige D. Wartko, Phd, MPHResearch Associate |
 Andrea Z. LaCroix, PhDSenior Investigator, KPWHRI; Professor and Chief of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego |
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
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KPWHRI In the Media
Kaiser Permanente researchers explore patients’ marijuana use
Fertility: The problem with weed: For men, getting high may have unexpected consequences
Seattle Magazine, April 2018
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Esketamine: How to assess new antidepressant’s efficacy
Dr. Gregory Simon says research is needed to see if this new drug for persistent depression will prevent suicides.
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KPWHRI In the Media
Opioids may raise risk for serious infections
Another downside to opioid use: Pneumonia?
HealthDay (syndicated), Feb. 12, 2018
marijuana use
Kaiser Permanente researchers explore patients’ marijuana use
Routinely asking about cannabis use can better serve patients by helping clinicians start conversations about risks and benefits.
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