BACKGROUND/RATIONALE:
Ineffective drug-therapy monitoring is a leading cause of adverse drug events (ADEs). Various drug-monitoring strategies have been developed through expert consensus. However, there is a lack of empirical evidence to guide monitoring decisions. The problem of scant evidence is compounded by the lack of established methods for comparing drug-monitoring strategies.

OBJECTIVE(S):
Aim 1: Examine serum-potassium monitoring practices in veterans who receive inhibitors of the renin-angiotensin-aldosterone system.
Aim 2: Assess the effect of adherence to recommended monitoring strategies on occurrence of severe- hyperkalemia.
Aim 3: Identify improved laboratory testing strategies for veterans who receive inhibitors of the renin-angiotensin-aldosterone system.

METHODS:
National VA DSS NDE data and vitals will be used to assess Aims 1 and 2. Simulation is being used to evaluate the causal inference analytic techniques.

FINDINGS/RESULTS:
Not yet available.

IMPACT:
Many drug therapies require safety monitoring. Little evidence exists to support guidance for risk specific monitoring recommendations. The findings from this study are expected to provide evidence for optimal monitoring of RAAS therapies. The approach developed for evaluating and optimizing RAAS therapies can be applied to develop evidence based monitoring strategies for other drug therapies. I plan to work with PBM VA MEDSafe and the OQP to disseminate our research findings and monitoring strategies.

We are developing methods to improve the transparency, reproducibility and credibility of VHA database research. The implications are huge for a learning healthcare system such as the VA.

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External Links for this Project

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PUBLICATIONS:

None at this time.

DRA: Health Systems Science
DRE: Treatment - Observational
Keywords: none
MeSH Terms: none