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
Dublin S, Walker RL, Gray S, Hubbard RA, Anderson ML, Yu O, Montine TJ, Crane PK, Sonnen JA, Larson EB. Use of analgesics (opioids and nonsteroidal anti-inflammatory drugs) and dementia related neuropathology in a community-based autopsy cohort. J Alzheimers Dis. 2017;58(2):435-448. doi: 10.3233/JAD-160374. PubMed
Hart R, Veenstra DL, Boudreau DM, Roth JA. The impact of body mass index and genetics on warfarin major bleeding outcomes in a community setting. Am J Med. 2016 Sep 1. pii: S0002-9343(16)30860-9. doi: 10.1016/j.amjmed.2016.08.017 [Epub ahead of print]. PubMed
Thielke S, Shortreed SM, Saunders K, Turner JA, LeResche L, Von Korff M. Predictors of continuing opioid use at one year among chronic pain patients. Clin J Pain. 2016 Jul 15. [Epub ahead of print]. PubMed
Thielke S, Shortreed SM, Saunders K, Turner JA, LeResche L, von Korff M. A prospective study of predictors of long-term opioid use among patients with chronic non-cancer pain. Clin J Pain. 2016 Jul 15. [Epub ahead of print]. PubMed
Morris C, Paul K, Safranek S. Procalcitonin-guided antibiotic therapy for acute respiratory infections. Am Fam Physician. 2016 Jul 1;94(1):53-8. No abstract available. PubMed
Researchers in Medication Use & Patient Safety
 Jennifer C. Nelson, PhDDirector of Biostatistics; Senior Investigator |
 Denise M. Boudreau, PhDSenior Investigator |
 Andrea J. Cook, PhDSenior Investigator |
 Sascha Dublin, MD, PhDSenior Investigator |
 Michael L. Jackson, PhD, MPHAssociate Investigator |
 Andrea Z. LaCroix, PhDSenior Investigator, KPWHRI; Professor and Chief of Epidemiology, Department of Family Medicine and Public Health, University of California, San Diego |
 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 |
 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 |
 Diana L. Miglioretti, PhDSenior Investigator, KPWHRI; Dean’s Professor of Biostatistics, University of California, Davis |
 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 |
 Jessica Chubak, PhD, MBHLSenior Investigator |
 Susan M. Shortreed, PhDSenior Investigator |
 Karen Wernli, PhDAssociate Investigator |
 Ellen O'Meara, PhDResearch Associate |
 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 |
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
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.
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
medication safety
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.
Medical Overuse
In health care, more isn’t always better. We know what to do less of, but how?
Our ‘Taking Action on Overuse’ framework helps organizations build a culture where care teams take ownership for reducing low value care. But what does that look like?
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.
Read it in News and Events.
Addiction
Unbroken Brain: A Revolutionary New Way of Understanding Addiction — Required reading for policymakers?
A science journalist living with addiction says it may be a learning disorder. Virginia Immanuel reviews Maia Szalavitz’ book about comprehensive addiction solutions.
Read it in Healthy Findings.
