BROAD TOPIC AREAS

Research Groups

The research conducted by faculty in the PHARE Study Group falls into three broad topic areas. Faculty generally conduct research with one or two of these groups.

Pharmacoepidemiologic Research: Members of the PHARE Study Group conduct studies designed to improve knowledge about the risks and benefits of medications in patient populations systematically excluded from clinical trials. Toward this end, our team has conducted geriatric pharmacoepidemiologic studies in nursing homes and medication safety studies in pregnancy women (collaboratively with Drs. Hedvig Nordeng, Mollie Wood, and Angela Lupatelli at the University of Oslo PharmaTox Research Group). We conduct burden of illness studies, describe medication utilization in vulnerable populations, evaluate the impact of policies on medication utilization, quantify the beneficial effects of treatments in patients systematically excluded from trials, and the unintended sequelae from medications in patients excluded from clinical trials. In addition to this work, members of the PHARE Study group, led by Dr. ShaoHsien Liu, seek to conduct research on how to delay osteoarthritis disease progression and how to alleviate symptoms in osteoarthritis. Studies using the National Osteoarthritis Initiative cohort have included the role of physical activity, NSAIDs, glucosamine/chondroitin, and intra-articular injections on outcomes in osteoarthritis. We have active collaborations with Brown University (Dr. Charles Eaton) and Tufts (Drs. Tim McAlindon and Jeffrey Driban).

Long Term Care Settings:  Members of the PHARE Study group have conducted research to document the care quality in nursing homes and other long term care settings. In nursing homes, we have developed research programs related to stroke, heart failure, mental health, and pain (and its management). In-house we have national, comprehensive, longitudinal Minimum Data Set 3.0 data cross-linked to Medicare claims (Parts A, B, and D).

PHARE researchers have also been generating innovative analyses regarding sexual and gender minority populations. A paper under review at Medical Care describes the satisfaction with healthcare among transgender women, men, and gender non-conforming finds that, while most transgender individuals are able to find care that they are very satisfied with, the proportion of transgender men not at all satisfied with their healthcare is higher than any other group. Student-led research on the relationships between state antidiscrimination policy and frequent mental distress among 96 populations defined at the intersection of gender identity, sexual orientation, and race/ethnicity is well underway, as is a collaborative paper with colleagues from Boston University and Johns Hopkins University examining the differential distribution of adverse childhood experiences among sexual and gender minority populations, as well as their relationships with adult binge drinking and frequent mental distress. A collaboration with the National LGBT Cancer Center is estimating state-level prevalence of tobacco use across sexual and gender minority populations to share with local policy makers. Finally, in a dataset of persons receiving insurance through employers, we are examining trends in the prevalence of people identifiable as receiving gender transition services in light of recent expansions of state and Federal policies regarding insurance coverage and antidiscrimination laws.