Older adults comprise 13% of the population yet account for up to one third of prescribed medications in the US. On average, older adults take three to five different medications concurrently. Older adults are at increased risk of serious adverse drug events (such as falls, depression, and delirium) because of the presence of multiple chronic conditions, having more than one prescriber, use of multiple medications, inappropriate prescribing and monitoring of medications, and age-related physiological changes. Pharmacoepidemiology applies methods of chronic disease epidemiology to the study of drugs in populations. Pharmacoepidemiologic studies commonly involve the evaluation of adverse and beneficial drug effects, medication use patterns, and economic impacts of medication use. Pharmacoepidemiology is increasingly important in aging research due to increased life expectancy, increased numbers of older adults, availability of new drugs for treatment of acute and chronic conditions that are common in the elderly, and availability of data and methods to study drug use and outcomes in this population.
Trainees have access to public and proprietary databases, as well as expert data management support that is required for pharmacoepidemiologic studies involving large databases. Faculty have expertise in working with multiple datasets, including Surveillance, Epidemiology, and End Results/Medicare, Medicare Current Beneficiary Survey, Chronic Condition Warehouse, IMS Lifelink, National Health Interview Survey, Medical Expenditure Panel Survey, National Ambulatory Medical Care Survey, and National Health and Nutrition Examination Survey. Faculty also have built longitudinal analytic files to study outcomes associated with a variety of indicators of appropriateness of medication use. Faculty have conducted NIA-sponsored work in multi-morbidity and medication adherence/outcomes in older adults with chronic obstructive pulmonary disease and depression, as well as AHRQ-sponsored work in traumatic brain injury. Continuing work in geriatric pharmacoepidemiology includes opioid and other prescription medication use disorders, aging in place, falls prevention, medication therapy management, and sleep disorders.
Patterns of Depression Treatment in Medicare Beneficiaries with Depression after Traumatic Brain Injury. Albrecht JS, Kiptanui Z, Tsang Y, et al. Journal of neurotrauma. 2015;32(16):1223-1229.
Risk of Stroke Among Older Medicare Antidepressant Users With Traumatic Brain Injury. Khokhar B, Simoni-Wastila L, Albrecht JS. The Journal of head trauma rehabilitation. 2017;32(1):E42-e49.
Use of Drugs with Anticholinergic Properties among Nursing Home Residents with Dementia: A National Analysis of Medicare Beneficiaries Palmer JB, Albrecht JS, Park Y, et al. 2007-2008. Drugs & aging. 2015;32(1):79-86.
The Pharmacogenomics of Anti-Platelet Intervention (PAPI) Study: Variation in Platelet Response to Clopidogrel and Aspirin. Bozzi LM, Mitchell BD, Lewis JP, et al. Current vascular pharmacology. 2016;14(1):116-124.
A Systematic Review of the Benefits and Risks of Anticoagulation Following Traumatic Brain Injury. TShen X, Dutcher SK, Palmer J, et al.he Journal of head trauma rehabilitation. 2015;30(4):E29-37.
Effect of medications on physical function and cognition in nursing home residents with dementia. Dutcher SK, Rattinger GB, Langenberg P, et al. J Am Geriatr Soc. 2014;62(6):1046-1055.
Pharmacotherapeutic management of dementia across settings of care. Rattinger GB, Burcu M, Dutcher SK, et al. J Am Geriatr Soc. 2013;61(5):723-733.
The Effect of Dementia on Medication Use and Adherence Among Medicare Beneficiaries With Chronic Heart Failure. Rattinger GB, Dutcher SK, Chhabra PT, et al. The American journal of geriatric pharmacotherapy. 2012;10(1):69-80.
Medication reconciliation during the transition to and from long-term care settings: a systematic review. Chhabra PT, Rattinger GB, Dutcher SK, Hare ME, Parsons KL, Zuckerman IH.Research in social & administrative pharmacy : RSAP. 2012;8(1):60-75.
Adherence to Maintenance Medications among Older Adults with Chronic Obstructive Pulmonary Disease. The Role of Depression. Albrecht JS, Park Y, Hur P, et al. Annals of the American Thoracic Society. 2016;13(9):1497-1504.
Older Adult Self-Efficacy Study of Mobile Phone Diabetes Management. Quinn CC, Khokhar B, Weed K, Barr E, Gruber-Baldini AL. Diabetes technology & therapeutics. 2015;17(7):455-461.
The relationship between the low-income subsidy and cost-related nonadherence to drug therapies in Medicare Part D. Wei, II, Lloyd JT, Shrank WH. J Am Geriatr Soc. 2013;61(8):1315-1323.
Increased persistency in medication use by U.S. Medicare beneficiaries with diabetes is associated with lower hospitalization rates and cost savings. Stuart BC, Simoni-Wastila L, Zhao L, Lloyd JT, Doshi JA Diabetes Care. 2009;32(4):647-649.
Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries. Zuckerman IH, Ryder PT, Simoni-Wastila L, et al.J Gerontol B Psychol Sci Soc Sci. 2008;63(5):S328-333.
Complementary and alternative medicine use among older urban African Americans: individual and neighborhood associations. JRyder PT, Wolpert B, Orwig D, Carter-Pokras O, Black SA Journal of the National Medical Association. 2008;100(10):1186-1192.