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
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
Owens MD, Chen JA, Simpson TL, Timko C, Williams EC. Barriers to addiction treatment among formerly incarcerated adults with substance use disorders. Addict Sci Clin Pract. 2018;13(1):19. doi: 10.1186/s13722-018-0120-6. PubMed
Gray SL, Anderson ML, Hanlon JT, Dublin S, Walker RL, Hubbard RA, Yu O, Montine TJ, Crane PK, Sonne JA, Keene CD, Larson EB. Exposure to strong anticholinergic medications and dementia-related neuropathology in a community-based autopsy cohort. J Alzheimers Dis. 2018 Jul 21. pii: JAD171174. doi: 10.3233/JAD-171174. [Epub ahead of print]. PubMed
Casillas A, Moreno G, Grotts J, Tseng CH, Morales LS. A digital language divide? the relationship between internet medication refills and medication adherence among limited English proficient (LEP) patients. J Racial Ethn Health Disparities. 2018 Mar 29. pii: 10.1007/s40615-018-0487-9. doi: 10.1007/s40615-018-0487-9. [Epub ahead of print]. PubMed
Dublin S, Von Korff M. Prescription Opioids and Infection Risk: Research and Caution Needed. Ann Intern Med. 2018;168(6):444-445. doi: 10.7326/M18-0001. Epub 2018 Feb 13. PubMed
Researchers in Medication Use & Patient Safety
 Sascha Dublin, MD, PhDSenior Investigator |
 Jessica Chubak, PhDSenior Investigator |
 Andrea J. Cook, PhDSenior Biostatistics Investigator |
 Rita Mangione-Smith, MD, MPHExecutive Director and Senior Investigator, KPWHRI; Vice President for Research and Health Care Innovation, Kaiser Permanente Washington |
 Jennifer C. Nelson, PhDDirector, Biostatistics; Senior Investigator |
 David E. Arterburn, MD, MPHSenior Investigator |
 Susan M. Shortreed, PhDSenior Biostatistics Investigator |
 Lisa A. Jackson, MD, MPHSenior Investigator |
 Karen Wernli, PhDSenior Investigator |
 Onchee Yu, MSPrincipal Collaborative Biostatistician |
 Rod L. Walker, MSPrincipal Collaborative Biostatistician |
 Robert D. Wellman, MSPrincipal Collaborative Biostatistician |
 Gaia Pocobelli, PhDSenior Collaborative Scientist |
 Laura Harrington, PhD, MPHAssistant Investigator |
 Jennifer F. Bobb, PhDAssociate Biostatistics Investigator |
 Weiwei Zhu, MSSenior Collaborative Biostatistician |
 Paige D. Wartko, PhD, MPHSenior Collaborative Scientist |
 Maricela Cruz, PhDAssistant Biostatistics Investigator |
 Brian D. Williamson, PhDAssistant Biostatistics Investigator |
 Noorie Hyun, PhDAssociate Biostatistics Investigator |
 Laurel Hansell, MA, MPHCollaborative Scientist |
 Jess Mogk, MPHCollaborative Scientist |
 Annie Piccorelli, PhDSenior Collaborative Biostatistician |
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
Research roundup
What's new in cannabis use research?
Use in pregnancy and screening in primary care studied by KPWHRI’s Kiel, Matson, and Lapham.
Research
IUD perforation: Rare but important to know about
New study results in more precise language in the federally mandated warning about this possibility.
Research
New findings on treating hypertension in pregnancy
A study led by Dr. Sascha Dublin finds similar outcomes for 3 hypertension medications, filling an evidence gap.
COVID-19 treatments
New report supports value of COVID-19 drugs
A team led by KPWHRI's Kai Yeung, PharmD, PhD, reviewed trial results for cost-effectiveness of 3 treatments.
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.
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