Select Research Projects

Our work aims to make a difference, so that we can continuously improve outcomes in the prevention, treatment, and management of health conditions.

Below is a select overview of some of our projects that have helped shape the delivery of healthcare in our community, and beyond.

Improving Post Hospital Medication Management of Older Adults Through Health IT

MPCI Investigators: Jerry H. Gurwitz, Terry S. Field, Jennifer Tjia, Jennifer Donovan, Abir O. Kanaan, Lawrence Garber, Sarah L. Cutrona, Leslie Harrold
Funding Agency: Agency for Healthcare Research and Quality
Research Area: Patient Safety and Quality Improvement  

Project Overview: The goals of this study were to evaluate the impact of providing information through an HIT-based transitional care intervention on the post hospital discharge rate of follow-up to an outpatient provider, prevalence of appropriate monitoring for selected high-risk medications, incidence of adverse drug events, and rate of hospital readmission / emergency department visits among a population of older adults. Learn more

Main Findings: We found that implementation of an automated alert system to provide information about patient transitions to primary care physicians requires strong internal informatics expertise, cooperation between facilities and ambulatory providers, development of a number of electronic linkages, and extensive commitment of physician time. The effectiveness of the alert system is being assessed in a randomized trial.

Medication Exposure in Pregnancy Risk Evaluation Program (MEPREP)

MPCI Investigator: Susan E. Andrade
Funding Agency: U.S. Food and Drug Administration
Research Area: Pharmacoepidemiology and Medication Safety

Project Overview: About two-thirds of women who deliver a baby have taken at least one prescription medication during pregnancy; however, there are very few clinical trials that evaluate the safety of medications in pregnancy due to concerns about the health of the mother and child. The goals of this pilot project were to use administrative data linked to birth certificate data to evaluate the use and safety of medications during pregnancy. Learn more

Main Findings: At the 11 health plans, we linked health care information on 1,221,156 children delivered to 933,917 mothers during the period 2001 to 2008. The use of a number of different medication classes increased dramatically over the study period. There was a 2.5-fold increase in atypical antipsychotic use during the study period, from 0.33% (95% confidence interval: 0.29%, 0.37%) in 2001 to 0.82% (0.76%, 0.88%) in 2007. We also found over a five-fold increase in the use of newer anti-epileptic drugs and newer asthma medications (leukotriene receptor antagonists) during the study period. Studies are needed to examine the comparative safety and effectiveness of medications during pregnancy.

Management and Outcomes of Heart Failure with Preserved Systolic Function (PRESERVE)

MPCI Investigators: Jerry H. Gurwitz, Jane Saczynski, Robert Goldberg, David McManus
Funding Agency: National Heart, Lung, and Blood Institute
Research Area: Epidemiology of Chronic Diseases

Project Overview: The goals of the PRESERVE project were to characterize treatment patterns among adults with heart failure and documented preserved left ventricular systolic function and to evaluate the effectiveness of the treatments. Learn more

Main Findings: Heart failure with preserved left ventricular ejection fraction is the most common form of the heart failure syndrome among patients newly presenting with this condition, and women and older adults are especially affected. Evidence-based treatment strategies apply to less than one third of patients with newly diagnosed heart failure.

Health Literacy and Cancer Prevention: Do People Really Understand What They Hear?

MPCI Investigators: Kathleen M. Mazor, Terry S. Field, Sarah L. Cutrona
Funding Agency: National Cancer Institute
Research Area: Communication in Healthcare

Project Overview: The goals of this project were to develop and validate a psychometrically sound test to assess comprehension of spoken messages about cancer and cancer prevention, and to investigate the relationship between health literacy and cancer prevention behaviors. Learn more

Main Findings: We developed two new health literacy tests, the Cancer Message Literacy Test–Listening and the Cancer Message Literacy Test- Reading. These measures are now publicly available on the study website.  Manuscripts reporting the relationship between health literacy and cancer-related knowledge, beliefs, attitudes and behaviors are in progress. 

Breast Cancer Treatment Effectiveness in Older Women (BOW)

MPCI Investigator: Terry S. Field
Funding Agency: National Cancer Institute
Research Area: Organization and Delivery of Healthcare

Project Overview: Older women with early stage breast cancer have not been included in clinical trials in substantial numbers, leaving many open questions about the necessity of aggressive treatment and surveillance for women aged 65 years and older. The goals of this series of studies were to assess the impact of variations in care on recurrence and mortality and to compare long-term outcomes in breast cancer survivors to those of age-matched women without a history of breast cancer.  Learn more

Main Findings: Advancing age is tightly associated with marked differences in treatment. Independent of age, less than standard therapy is associated with increased rates of recurrence and breast cancer-specific mortality. Compared to age-matched women, five-year survivors of breast cancer have similar rates of osteoporotic fractures and incidence of cardiovascular disease.

Screening Effectiveness and Research in Community-Based Healthcare (SEARCH)

MPCI Investigators: Terry S. Field, Christopher Owens
Funding Agency: National Cancer Institute
Research Area: Comparative Effectiveness Research

Project Overview: The goal of this study was to compare the effectiveness of alternatives for delivery of cancer screening to populations. Two proof of concept projects were conducted comparing: 1) conventional vs. liquid-based cytology for cervical cancer screening and 2) colonoscopies vs. other screening options for prevention of late stage of colorectal cancer at diagnosis. Learn more

Main Findings: Use of liquid-based cytology lowered the rate of pap smears that could not be evaluated for one of the technologies adopted, but increased the rate for an alternative technology. Screening with colonoscopy in average-risk adults was associated with reduced risk for diagnosis of incident late-stage colorectal cancer, including right-sided colon cancer. 

Impact of Medicare Drug Benefit on Use and Cost-Related Underuse of Medicines

MPCI Investigators: Becky A. Briesacher, Jerry H. Gurwitz
Funding Agency: National Institute on Aging
Research Area: Healthcare Policy

Project Overview: The principal goal of this study was to measure changes in drug coverage, use, spending, and cost-related underuse of medicines among elderly Medicare beneficiaries before and after implementation of the Medicare Modernization Act, with a particular focus on poor and chronically ill beneficiaries who will qualify for substantially subsidized coverage and near-poor beneficiaries who will not. Learn more

Main Findings: Data from 2006 indicated modest nationwide decreases in cost-related medication non-adherence and forgoing basic needs following Part D implementation, and most decreases occurred among healthiest beneficiaries. After the transition year of 2006, the impact of Part D seemed larger and more consistent across the Medicare population. Of note, sick and poor beneficiaries experienced significant improvements in prescription drug use in 2007.

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