Research Projects

In addition to the V-RIDI study, Dr. Thorpe leads and collaborates on a number of other studies concerned with the safe and effective use of medications.

Communication about Type 2 Diabetes Treatment Decisions in Older Patients with Comorbid Dementia

Dr. Thorpe leads a qualitative pilot study consisting of semi-structured interviews with healthcare providers and caregivers aimed at understanding (1) the process by which glycemic goals and prescribing decisions for older patients with type 2 diabetes and comorbid dementia are made; and (2) patient, provider, caregiver, and system-level barriers to pursuing moderate glycemic control in diabetes patients with dementia. A one-year, $20,000 grant from the Aging Institute of UPMC Senior Services and the University of Pittsburgh supports this research.

Supporting Medication Adherence in Veterans with Dementia and Their Caregivers

Dr. Thorpe has been awarded a $35,000 pilot grant from the Center for Health Equity Research and Promotion (CHERP) and the VISN4 VA Healthcare Network within the Department of Veterans Affairs. This pilot study is designed to inform the development of comprehensive interventions to support caregivers’ ability to assist dementia patients with adhering to medications. Toward this goal, the researchers will 1) Determine feasibility of incorporating a structured tool for assessing the capacity of patients to self-management medications into geriatrics outpatient care and examine its ability to identify dementia patients with poor adherence; 2) Develop preliminary data on the effect of incorporation of this tool on caregiver activation to assist with medications, caregiver medication beliefs and self-efficacy, and patient adherence; and 3) Describe the prevalence and strength of association of barriers and facilitators to adherence experienced by caregivers of patients with dementia.

Guideline Adherence and Short/Long-term Health Outcomes in Patients with Diabetes

Dr. Thorpe also leads a sub-award on a grant to colleagues at the University of Wisconsin – Madison from the Agency for Healthcare Research and Quality (AHRQ) focused on the optimal treatment of complex patients who have diabetes. The overall project uses healthcare claims linked to electronic health record data to examine the role of patient comorbidity in the relationship between treatment for glycemic, lipid, and blood pressure control and health outcomes. Dr. Thorpe directs the third aim of this study which is comparing the effect of different medication regimens used for glycemic control on adverse drug events, including falls and fractures.

National VA Survey on Prescribing and Medication Safety

On behalf of VA Pharmacy Benefits Management, Dr. Thorpe is leading a national survey of VA physicians to examine several high-priority medication safety and quality issues currently facing the VA. This survey examines provider perceptions and experiences regarding prescribing of non-formulary medications, coordination of VA medication therapy with non-VA medication therapy, and communication processes regarding medications within VA facilities.

Other Collaborations

Dual Use of Medicare Part D and Unsafe Prescribing

PI: Joshua Thorpe, PhD, MPH, VAPHS and University of Pittsburgh

Funder: Health Services Research and Development (HSR&D), Department of Veterans Affairs

This project aims to improve the safety and appropriateness of prescribing for Veterans with dementia who are dually eligible for VA and Medicare Part D pharmacy benefits by examining the extent of medication seeking outside VA, identifying the reasons Veterans with dementia seek medications outside the VA, and identifying potential mechanisms by which dual use impacts prescribing safety and outcomes.

Safety of Opioid Use among Veterans Receiving Care in Multiple Health Systems

PI: Walid Gellad, MD, MPH, VAPHS, University of Pittsburgh, and RAND

Funder: Health Services Research and Development (HSR&D), Department of Veterans Affairs

The goal of this mixed methods study is to describe the patterns of opioid use from VA and non-VA sources among Veterans enrolled in VA healthcare, and to understand the determinants and health consequences of dual use.

Use and Discontinuation of Antidementia Drugs in a National Sample and Perspectives from Regional Stakeholders

PI: Nicole Fowler, PhD, University of Pittsburgh

Funder: RAND-University of Pittsburgh Health Institute (RUPHI)

This study will use Medicare claims data to measure, describe, and compare the factors that predict initiation and discontinuation of anti-dementia drugs, and interviews with patients and caregivers to describe the structure of the decision-making process regarding medication initiation and discontinuation.

PIVOTS: Pharmacist-led InterVention on Transitions of Seniors

PI: Heather Sakely

Funder: ASHP Foundation and Jewish Healthcare Foundation

This project evaluates a novel team-based  care model involving the pharmacist as a provider of continuous medication therapy management to older adults across outpatient, inpatient, and long-term care settings.

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