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:

"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."

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Researchers in medication use & patient safety

GHRI

Affiliate researchers

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Recent publications on medication use & patient safety

2008

Andrade SE, Raebel MA, Brown J, Lane K, Livingston J, Boudreau D, Rolnick SJ, Roblin D, Smith DH, Willy ME, Staffa JA, Platt R. Use of antidepressant medications during pregnancy: a multisite study. Am J Obstet Gynecol. 2008;198(2):194.e1-5. Epub 2007 Oct 1. PubMed

Boudreau DM, Koehler E, Rulyak SJ, Haneuse S, Harrison R, Mandelson MT. Cardiovascular medication use and risk for colorectal cancer. Cancer Epidemiol Biomarkers Prev. 2008 Oct 28. [Epub ahead of print]. PubMed

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

Psaty BM, Vandenbroucke JP. Opportunities for enhancing the FDA guidance on pharmacovigilance. JAMA. 2008;300(8):952-4. PubMed

Wetmore CM, Ichikawa L, Lacroix AZ, Ott SM, Scholes D. Association between caffeine intake and bone mass among young women: potential effect modification by depot medroxyprogesterone acetate use. Osteoporos Int. 2008;19(4):519-27. Epub 2007 Oct 9. PubMed

2007

Boudreau DM, Yu O, Miglioretti DL, Buist DS, Heckbert SR, Daling JR. Statin use and breast cancer risk in a large population-based setting. Cancer Epidemiol Biomarkers Prev. 2007;16(3):416-21. PubMed

Brown JS, Kulldorff M, Chan KA, Davis RL, Graham D, Pettus PT, Andrade SE, Raebel MA, Herrinton L, Roblin D, Boudreau D, Smith D, Gurwitz JH, Gunter MJ, Platt R. Early detection of adverse drug events within population-based health networks: application of sequential testing methods. Pharmacoepidemiol Drug Saf. 2007;16(12):1275-84. PubMed

Chubak J, Buist DS, Boudreau DM, Rossing MA, Lumley T, Weiss NS. Breast cancer recurrence risk in relation to antidepressant use after diagnosis. Breast Cancer Res Treat. 2007; [Epub ahead of print]. PubMed

Glazer NL, Dublin S, Smith NL, French B, Jackson LA, Hrachovec JB, Siscovick DS, Psaty BM, Heckbert SR. Newly detected atrial fibrillation and compliance with antithrombotic guidelines. Arch Intern Med. 2007;167(3):246-52. PubMed

Larson E, McCurry S. Olanzapine, quetiapine, or risperidone did not differ from placebo for Alzheimer disease. ACP J Club. 2007;146(2):35. PubMed

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Our major research interests

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