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
Gray SL, Marcum ZA, Schmader KE, Hanlon JT. Update on medication use quality and safety in older adults, 2017. J Am Geriatr Soc. 2018 Nov 13. doi: 10.1111/jgs.15665. [Epub ahead of print]. PubMed
Dublin S, Walker RL, Shortreed SM, Ludman EJ, Sherman KJ, Hansen RN, Thakral M, Saunders K, Parchman ML, Von Korff M. Impact of initiatives to reduce prescription opioid risks on medically attended injuries in people using chronic opioid therapy. Pharmacoepidemiol Drug Saf. 2019 Jan;28(1):90-96. doi: 10.1002/pds.4678. Epub 2018 Oct 30. PubMed
Chen Y, Wang J, Chubak J, Hubbard RA. Inflation of type I error rates due to differential misclassification in EHR-derived outcomes: empirical illustration using breast cancer recurrence. Pharmacoepidemiol Drug Saf. 2018 Oct 30. doi: 10.1002/pds.4680. [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. 2019 Jun;15(6):754-760. doi: 10.1016/j.sapharm.2018.09.007. Epub 2018 Sep 14. PubMed
Von Korff M, Saunders K, Dublin S, Walker RL, Thakral M, Sherman KJ, Ludman EJ, Hansen RN, Parchman M, Shortreed SM. Impact of chronic opioid therapy risk reduction initiatives on opioid overdose. 2019 Jan;20(1):108-117. doi: 10.1016/j.jpain.2018.08.003. Epub 2018 Sep 3. PubMed
Researchers in Medication Use & Patient Safety
 Sascha Dublin, MD, PhDSenior Investigator |
 Jessica Chubak, PhD, MBHLSenior Investigator |
 Andrea J. Cook, PhDSenior 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 |
 Jennifer C. Nelson, PhDDirector of Biostatistics; Senior Investigator |
 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, MSBiostatistician III |
 Rod L. Walker, MSBiostatistician III |
 Robert D. Wellman, MSBiostatistician III |
 Gaia Pocobelli, PhDResearch Associate |
 David S. Carrell, PhDAssociate Investigator |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Jennifer F. Bobb, PhDAssociate Investigator |
 Weiwei Zhu, MSBiostatistician III |
 Paige D. Wartko, PhD, MPHResearch Associate |
 Maricela Cruz, PhDAssistant Investigator |
 Brian D. Williamson, PhDAssistant 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
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.
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
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