Cost-related Medication Nonadherence and the Health of Older Adults Becky Briesacher, Ph.D., is a health services researcher and Assistant Professor of Medicine in the Division of Geriatric Medicine at the University of Massachusetts Medical School. Her long-term career goal is to become an independently-funded researcher supported by rich mentorship and fruitful collaborations in the area of aging and drug policy. Dr. Briesacher seeks a Mentored Research Scientist Development Award (K01) to gain: (1) a better understanding of cost-related medication nonadherence (CRN) and its effect on the health of older adults, and (2) research experience with models that account for irrationality in health behaviors. The candidate proposes a career development plan that provides new training in behavioral economics, targeted exposure to clinical geriatrics, and advanced statistical methods in longitudinal analyses. The research program includes: (1) creating a unique, longitudinal dataset from two national health surveys of older adults, (2) describing the longitudinal course of CRN, including identifying the predictors and potential consequences on patient health and health care expenditures, and (3) developing models of CRN in older adults that incorporate principles from behavioral economics, particularly time-inconsistency. The advanced training and three-part research program will provide the foundation for Dr. Briesacher's transition to an independent investigator in geriatric health services research. In addition, this research program will inform issues central to Medicare Part D prescription drug program and its effects on the health and financial stability of older adults.

Public Health Relevance

Strong evidence shows that medication adherence decreases with higher cost-sharing, yet medication cost- sharing is rising, most notably in Medicare Part D. Discovering how optimal cost-sharing may improve medication adherence has significant implications for the health and welfare of an aging society that is increasingly dependent on medications.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01AG031836-05
Application #
8314020
Study Section
National Institute on Aging Initial Review Group (NIA)
Program Officer
Haaga, John G
Project Start
2008-09-30
Project End
2013-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
5
Fiscal Year
2012
Total Cost
$124,940
Indirect Cost
$9,255
Name
University of Massachusetts Medical School Worcester
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
603847393
City
Worcester
State
MA
Country
United States
Zip Code
01655
Briesacher, Becky A; Madden, Jeanne M; Zhang, Fang et al. (2015) Did Medicare Part D Affect National Trends in Health Outcomes or Hospitalizations? A Time-Series Analysis. Ann Intern Med 162:825-33
Tjia, Jennifer; Field, Terry; Mazor, Kathleen et al. (2015) Dissemination of Evidence-Based Antipsychotic Prescribing Guidelines to Nursing Homes: A Cluster Randomized Trial. J Am Geriatr Soc 63:1289-98
Pimentel, Camilla B; Briesacher, Becky A; Gurwitz, Jerry H et al. (2015) Pain management in nursing home residents with cancer. J Am Geriatr Soc 63:633-41
Pimentel, Camilla B; Donovan, Jennifer L; Field, Terry S et al. (2015) Use of atypical antipsychotics in nursing homes and pharmaceutical marketing. J Am Geriatr Soc 63:297-301
Tjia, Jennifer; Briesacher, Becky A; Peterson, Daniel et al. (2014) Use of medications of questionable benefit in advanced dementia. JAMA Intern Med 174:1763-71
Tjia, Jennifer; Field, Terry; Lemay, Celeste et al. (2014) Antipsychotic use in nursing homes varies by psychiatric consultant. Med Care 52:267-71
Pimentel, Camilla B; Lapane, Kate L; Briesacher, Becky A (2013) Medicare part D and long-term care: a systematic review of quantitative and qualitative evidence. Drugs Aging 30:701-20
Johnson, Eric S; Bartman, Barbara A; Briesacher, Becky A et al. (2013) The incident user design in comparative effectiveness research. Pharmacoepidemiol Drug Saf 22:1-6
Lemay, Celeste A; Mazor, Kathleen M; Field, Terry S et al. (2013) Knowledge of and perceived need for evidence-based education about antipsychotic medications among nursing home leadership and staff. J Am Med Dir Assoc 14:895-900
Briesacher, Becky A; Soumerai, Stephen B; Zhang, Fang et al. (2013) A critical review of methods to evaluate the impact of FDA regulatory actions. Pharmacoepidemiol Drug Saf 22:986-94

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