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.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Scientist Development Award - Research & Training (K01)
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National Institute on Aging Initial Review Group (NIA)
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Haaga, John G
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University of Massachusetts Medical School Worcester
Internal Medicine/Medicine
Schools of Medicine
United States
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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
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
Harrold, Leslie R; Briesacher, Becky A; Peterson, Dan et al. (2013) Cost-related medication nonadherence in older patients with rheumatoid arthritis. J Rheumatol 40:137-43
Briesacher, Becky A; Tjia, Jennifer; Field, Terry et al. (2013) Antipsychotic use among nursing home residents. JAMA 309:440-2
Tjia, Jennifer; Velten, Sarah J; Parsons, Carole et al. (2013) Studies to reduce unnecessary medication use in frail older adults: a systematic review. Drugs Aging 30:285-307
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
Tjia, Jennifer; Gurwitz, Jerry H; Briesacher, Becky A (2012) Challenge of changing nursing home prescribing culture. Am J Geriatr Pharmacother 10:37-46
Higgins, Angela Y; Doubeni, Anna R B; Phillips, Karon L et al. (2012) Self-reported colorectal cancer screening of Medicare beneficiaries in family medicine vs. internal medicine practices in the United States: a cross-sectional study. BMC Gastroenterol 12:23
Chen, Yong; Harrold, Leslie R; Yood, Robert A et al. (2012) Identifying patients with osteoporosis or at risk for osteoporotic fractures. Am J Manag Care 18:e61-7

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