Medication use & patient safety
The use and costs of prescription medications have been rising steadily. So society is struggling to make more informed decisions about whether the benefits of drugs outweigh their risks. It has become increasingly important to determine whether medications are safe, effective, and cost-effective in the general population. Clinical trials are essential in determining the efficacy of drugs, but they generally are not designed to detect meaningful differences in potentially rare adverse events. And they seldom represent such populations as children, women, minorities, and the elderly.
High-quality longitudinal data and a broad population base that represents the community make Group Health Cooperative an ideal setting for conducting this research. To answer questions on the safety and effectiveness of medications relevant to our community and nation, Group Health Research Institute (GHRI) researchers collaborate with the Group Health Pharmacy Department, the University of Washington, the Fred Hutchinson Cancer Research Center, and other health plans in the HMO Research Network (HMORN).
The Agency for Healthcare Research and Quality (AHRQ) funds the Centers for Education and Research on Therapeutics (CERTs), a national network of 14 research organizations, to conduct research and provide education on such issues. The CERTs, which AHRQ administers in consultation with the Food and Drug Administration (FDA), aim to advance better use of drugs, medical devices, and biological products. The multicenter research environment of the HMORN CERT brings several strengths to research in drug safety and effectiveness. These include using epidemiologic tools to study outcomes—usually adverse outcomes—associated with medication use; answering various questions about drug use, from economics to genetics; and assessing efforts to change the behavior of patients and health care providers.
By combining populations from 13 health plans, the HMORN CERT researchers can:
- Study nearly 4 percent of U.S. residents—enough to address many topics beyond the power of individual health plans.
- Investigate groups that are ethnically and geographically diverse.
- Work with a wide array of medical-care delivery models, representing various care patterns, benefits, and outcomes.
- Create research teams with greater expertise than any single plan can develop.
"Through our work, we provide scientific evidence that helps patients and providers make more informed decisions about health care," says Sascha Dublin, MD, PhD, assistant investigator at GHRI and Group Health principal investigator of the HMORN CERT. "Many benefits come from working collaboratively on these issues."
GHRI researchers in medication use & patient safety
Affiliate researchers
- Susan Heckbert, MD, PhD
Professor, Epidemiology
Scientific Investigator, Cardiovascular Health Research Unit
University of Washington (UW) - David Siscovick, MD, MPH
Professor, Medicine and Epidemiology
Co-Director, Cardiovascular Health Research Unit, UW
Recent publications on medication use & patient safety
2010
Boudreau DM, Yu O, Johnson J. Statin use and cancer risk: a comprehensive review. Expert Opin Drug Saf. 2010 Jul;9(4):603-21. Epub 2010 Apr 9. PubMed
Chubak J, Boudreau DM, Rulyak SJ, Mandelson MT. Colorectal cancer risk in relation to antidepressant medication use. Int J Cancer. 2010 Mar 15. [Epub ahead of print]. PubMed
Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, Weisner CM, Silverberg MJ, Campbell CI, Psaty BM, Von Korff M. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010;152(2):85-92. PubMed
2009
Breitner JC, Haneuse SJ, Walker R, Dublin S, Crane PK, Gray SL, Larson EB. Risk of dementia and AD with prior exposure to NSAIDs in an elderly community-based cohort. Neurology. 2009 Jun 2;72(22):1899-905. Epub 2009 Apr 22. PubMed
Chubak J, Bowles EJ, Terry MB, Trentham-Dietz A, Buist DS. Antidepressant medications and change in mammographic density in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2009;18(2):676-9. Epub 2009 Feb 3. PubMed
Dublin S, Jackson ML, Nelson JC, Weiss NS, Larson EB, Jackson LA. Statin use and risk of community acquired pneumonia in older people: population based case-control study. BMJ. 2009 Jun 16;338:b2137. DOI: 10.1136/bmj.b2137. PubMed
Weisner CM, Campbell CI, Ray GT, Saunders K, Merrill JO, Banta-Green C, Sullivan MD, Silverberg MJ, Mertens JR, Boudreau D, Von Korff M. Trends in prescribed opioid therapy for non-cancer pain for individuals with prior substance use disorders. Pain. 2009;145(3):287-93. Epub 2009 Jul 5. PubMed
2008
Heckbert SR, Li G, Cummings SR, Smith NL, Psaty BM. Use of alendronate and risk of incident atrial fibrillation in women. Arch Intern Med. 2008;168(8):826-31. PubMed
Psaty BM, Kronmal RA. Reporting mortality findings in trials of rofecoxib for Alzheimer disease or cognitive impairment: a case study based on documents from rofecoxib litigation. JAMA. 2008;299(15):1813-7. PubMed
Psaty BM, Ray W. FDA guidance on off-label promotion and the state of the literature from sponsors. JAMA. 2008;299(16):1949-51. PubMed
Our major research interests
- Aging & geriatrics
- Alternative approaches to healing
- Behavior change
- Biostatistics
- Cancer control
- Cardiovascular health
- Child & adolescent health
- Chronic illness management
- Health informatics
- Health services & economics
- Immunization & infectious diseases
- Medication use & patient safety
- Mental health
- Obesity
- Preventive medicine
- Women's health