Research Topics
| William ShrankSummaryAffiliation: Massachusetts General Hospital Country: USA Publications
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Publications
Is there a relationship between patient beliefs or communication about generic drugs and medication utilization?William H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts 02120, USA
Med Care 47:319-25. 2009..Insurers and policymakers strive to stimulate more cost-effective prescribing and, increasingly, are educating beneficiaries about generics...- An evaluation of the relationship between the implementation of a newly designed prescription drug label at Target pharmacies and health outcomesWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts 02120, USA
Med Care 47:1031-5. 2009..A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve health outcomes... 
Warnings without guidance: patient responses to an FDA warning about ezetimibeWilliam H Shrank
Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, Boston 02120, USA
Med Care 50:479-84. 2012..We investigated the proportion of patients who discontinued therapy and switched to a clinically appropriate alternative after the FDA communication...
Educating patients about their medications: the potential and limitations of written drug informationWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) 26:731-40. 2007..We suggest that oversight and standards are needed so that written drug information can serve as a coherent and organized system to educate patients...- Healthy user and related biases in observational studies of preventive interventions: a primer for physiciansWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02120, USA
J Gen Intern Med 26:546-50. 2011..More careful consideration of these sources of bias and study designs by providers can enhance evidence-based decision-making... - Patient, physician, pharmacy, and pharmacy benefit design factors related to generic medication useWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, 1620 Tremont St, Suite 3030, Boston, MA 02120, USA
J Gen Intern Med 22:1298-304. 2007..Increased use of generic medications conserves insurer and patient financial resources and may increase patient adherence... - The variability and quality of medication container labelsWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, 1620 Tremont St, Ste 3030, Boston, MA 02120, USA
Arch Intern Med 167:1760-5. 2007..Medication errors occur frequently, and poor medication labeling is cited as a potential cause. We assessed the format, content, and variability of prescription drug container labels dispensed in the community... - Quality indicators for medication use in vulnerable eldersWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02120, USA
J Am Geriatr Soc 55:S373-82. 2007 - Rationale and design of a randomized trial to evaluate an evidence-based prescription drug label on actual medication useWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital and Harvard Medical School, 1620 Tremont Street, Suite 300, Boston, MA 02120, USA
Contemp Clin Trials 31:564-71. 2010..Research shows that labels are variable, of poor quality, and not patient-centered. No real-world trials have evaluated whether improved medication labels can affect appropriate medication use, adherence or health outcomes... - State generic substitution laws can lower drug outlays under MedicaidWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Health Aff (Millwood) 29:1383-90. 2010..Although these consent requirements are probably intended to increase patient autonomy, policy makers should consider the sizable opportunity costs... - Can improved prescription medication labeling influence adherence to chronic medications? An evaluation of the Target pharmacy labelWilliam H Shrank
Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, 1620 Tremont Street Suite 3030, Boston, MA 02120, USA
J Gen Intern Med 24:570-8. 2009..A new prescription medication labeling system was implemented by Target pharmacies in May 2005 and aimed to improve readability and understanding... - Patients' perceptions of generic medicationsWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, at Brigham and Women s Hospital Harvard Medical School in Boston, Massachusetts, USA
Health Aff (Millwood) 28:546-56. 2009..These findings underscore the challenge that providers, insurers, and policymakers face in stimulating the cost-effective use of medications... - A blueprint for pharmacy benefit managers to increase valueWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, 1620 Tremont St, Ste 3030, Boston, MA 02120, USA
Am J Manag Care 15:87-93. 2009..Incentives for PBMs to promote value should drive innovation and improve health outcomes... - Effect of content and format of prescription drug labels on readability, understanding, and medication use: a systematic reviewWilliam Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, USA
Ann Pharmacother 41:783-801. 2007..To evaluate the evidence regarding the optimal content and format of prescription labels that might improve readability, understanding, and medication use... - Physician perceptions about generic drugsWilliam H Shrank
Brigham and Women s Hospital and Department of Medicine, Division of Pharmacoepidemiology and Pharmacoeconomics, Harvard Medical School, Boston, MA, USA
Ann Pharmacother 45:31-8. 2011..With constrained health-care resources, there is a need to understand barriers to cost-effective medication use... - The consequences of requesting "dispense as written"William H Shrank
Department of Medicine, Brigham and Women s Hospital, Boston, MA, USA
Am J Med 124:309-17. 2011..Patients also can make these requests. Little is known about the frequency and correlates of dispense as written requests or their association with medication filling... - The use of generic drugs in prevention of chronic disease is far more cost-effective than thought, and may save moneyWilliam H Shrank
CVS Caremark Harvard Partnership to Improve Medication Adherence, Brigham and Women s Hospital, Boston, MA, USA
Health Aff (Millwood) 30:1351-7. 2011..As the nation attempts to find strategies to improve population health without adding to the unsustainably high cost of care, policy makers should focus on ensuring that patients have access to essential generic medications... - Are caregivers adherent to their own medications?William H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02120, USA
J Am Pharm Assoc (2003) 51:492-8. 2011..To explore caregiver adherence to chronic medications and predictors of appropriate medication use... - Effect of physician reimbursement methodology on the rate and cost of cataract surgeryWilliam Shrank
Division of General Internal Medicine, Veterans Affairs Greater Los Angeles Health Care System, Los Angeles, Calif, USA
Arch Ophthalmol 123:1733-8. 2005..Previous research evaluating the relationship between physician reimbursement incentives and cataract surgical rates has been limited by physician and patient selection bias... - The implications of choice: prescribing generic or preferred pharmaceuticals improves medication adherence for chronic conditionsWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital and Harvard Medical School, Boston, Mass, USA
Arch Intern Med 166:332-7. 2006..We studied whether patients enrolled in such plans who receive generic or preferred brand-name agents when initiating chronic therapy were more adherent to treatment than those who received nonpreferred brand-name medications... - The effect of pharmacy benefit design on patient-physician communication about costsWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02120, USA
J Gen Intern Med 21:334-9. 2006..The impact of financial incentives on patient awareness of and communication about those costs is unknown... - Rationale and design of the Study Assessing the Effect of Cardiovascular Medications Provided as Low-cost, Evidence-based Generic Samples (SAMPLES) trialWilliam H Shrank
Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
Am Heart J 157:613-9. 2009..Highly effective generic cardiovascular medications are frequently underused, leading to greater overall drug costs and cost-related nonadherence... - The quality of pharmacologic care for adults in the United StatesWilliam H Shrank
Harvard Medical School, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Boston, MA 02120, USA
Med Care 44:936-45. 2006..We evaluated how frequently appropriate pharmacologic care is ordered in a national sample of U.S. residents... - Physicians' perceived knowledge of and responsibility for managing patients' out-of-pocket costs for prescription drugsWilliam H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02120 1613, USA
Ann Pharmacother 40:1534-40. 2006..Most insurers in the US have implemented incentive-based formularies that rely on out-of-pocket costs to influence prescription drug utilization. Medicare Part D plans have broadly adopted such benefit designs... - Physicians' perceptions of relevant prescription drug costs: do costs to the individual patient or to the population matter most?William H Shrank
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, 1620 Tremont Street, Ste 3030, Boston, MA 02120, USA
Am J Manag Care 12:545-51. 2006..We evaluated physicians' perceptions about relevant costs for prescription drugs and the importance of communication about these costs... - Adherence to lipid-lowering therapy and the use of preventive health services: an investigation of the healthy user effectM Alan Brookhart
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital Harvard Medical School, Boston, MA 02120, USA
Am J Epidemiol 166:348-54. 2007..Further work is needed to identify study design and analysis methods that can be used to minimize the healthy user bias in studies of preventive therapies... - A bitter pill: formulary variability and the challenge to prescribing physiciansWilliam H Shrank
Division of General Internal Medicine, VA Greater Los Angeles Health Care System, Los Angeles, CA 90073, USA
J Am Board Fam Pract 17:401-7. 2004..However, the degree of formulary variability among and within health plans over time is unclear... - Physician follow-up and provider continuity are associated with long-term medication adherence: a study of the dynamics of statin useM Alan Brookhart
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, Mass, USA
Arch Intern Med 167:847-52. 2007.... - Patient, physician, and payment predictors of statin adherenceDavid C Chan
Department of Medicine, Division of General Internal Medicine, Brigham and Women s Hospital, Boston, MA, USA
Med Care 48:196-202. 2010..Although many patient, physician, and payment predictors of adherence have been described, knowledge of their relative strength and overall ability to explain adherence is limited... - Highlights and a hidden hazard--the FDA's new labeling regulationsJerry Avorn
Harvard Medical School and Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women's Hospital, Boston, USA
N Engl J Med 354:2409-11. 2006 - A critical review of FDA-approved Medication GuidesMichael S Wolf
Institute for Healthcare Studies, Division of General Internal Medicine, Robert H Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, 676 N St Clair Street, Suite 200, Chicago, IL 60611, USA
Patient Educ Couns 62:316-22. 2006..To investigate whether consumer-directed, FDA-approved Medication Guides issued for potentially harmful medications are likely to be useful to patients with limited literacy... - Medicare beneficiaries' knowledge of and choices regarding Part D, 2005 to the presentJennifer M Polinski
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Boston, Massachusetts 02120, USA
J Am Geriatr Soc 58:950-66. 2010..Beneficiaries' knowledge and choices should be monitored on an ongoing basis to inform potential changes to the Part D program... - Changes in drug use and out-of-pocket costs associated with Medicare Part D implementation: a systematic reviewJennifer M Polinski
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Boston, Massachusetts, USA
J Am Geriatr Soc 58:1764-79. 2010..The effect of the Part D transition period remains unclear. Although public-use data will validate these results, policymakers can use the existing evidence to inform changes and enhancements to Part D immediately... - Online social networking by patients with diabetes: a qualitative evaluation of communication with FacebookJeremy A Greene
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA
J Gen Intern Med 26:287-92. 2011..These new sources of knowledge, support, and engagement have become important for patients living with chronic disease, yet the quality and content of the information provided in these digital arenas are poorly understood... - At Pitney Bowes, value-based insurance design cut copayments and increased drug adherenceNiteesh K Choudhry
Harvard Medical School, USA
Health Aff (Millwood) 29:1995-2001. 2010..Our study thus provides an empirical basis for the use of this approach to improve the quality of health care... - Primary medication non-adherence: analysis of 195,930 electronic prescriptionsMichael A Fischer
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Boston, MA 02120, USA
J Gen Intern Med 25:284-90. 2010..Little is known about the frequency with which patients fail to fill prescriptions when new medications are started ("primary non-adherence") or predictors of failure to fill... - Seizure outcomes following the use of generic versus brand-name antiepileptic drugs: a systematic review and meta-analysisAaron S Kesselheim
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts 02120, USA
Drugs 70:605-21. 2010..In the absence of better data, physicians may want to consider more intensive monitoring of high-risk patients taking AEDs when any switch occurs... - Completeness of retail pharmacy claims data: implications for pharmacoepidemiologic studies and pharmacy practice in elderly patientsJennifer M Polinski
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Boston, Massachusetts 02120, USA
Clin Ther 31:2048-59. 2009..Claims include only prescriptions filled at 1 pharmacy location or within 1 pharmacy chain and do not include prescriptions filled at outside pharmacies, potentially limiting research accuracy and pharmacy-based safety interventions... - The implications of therapeutic complexity on adherence to cardiovascular medicationsNiteesh K Choudhry
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital, Boston, MA 02120, USA
Arch Intern Med 171:814-22. 2011..Our objective was to estimate the extent of prescribing and filling complexity in patients prescribed a cardiovascular medication and to evaluate its association with adherence... - Measuring concurrent adherence to multiple related medicationsNiteesh K Choudhry
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Boston, MA 02120, USA
Am J Manag Care 15:457-64. 2009..To propose standardized methods for measuring concurrent adherence to multiple related medications and to apply these definitions to a cohort of patients with diabetes mellitus... - Do the incentives in 3-tier pharmaceutical benefit plans operate as intended? Results from a physician leadership surveyWilliam H Shrank
Division of General Internal Medicine, VA Greater Los Angeles Health Care System, Los Angeles, Calif 90073, USA
Am J Manag Care 11:16-22. 2005..Three-tier pharmaceutical benefit systems use graded co-payments to steer patients toward "preferred" formulary medications... - Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiariesNiteesh K Choudhry
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02120, USA
Circulation 117:1261-8. 2008.... - Rationale and design of the Post-MI FREEE trial: a randomized evaluation of first-dollar drug coverage for post-myocardial infarction secondary preventive therapiesNiteesh K Choudhry
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02120, USA
Am Heart J 156:31-6. 2008..Removing patient out-of-pocket drug costs may increase adherence, improve clinical outcomes, and even reduce overall health costs for high-risk patients. The existing data are inadequate to assess whether this strategy is effective... - Should patients receive secondary prevention medications for free after a myocardial infarction? An economic analysisNiteesh K Choudhry
Harvard Medical School and Brigham and Women s Hospital, Boston, Massachusetts, USA
Health Aff (Millwood) 26:186-94. 2007..Our analysis suggests that covering combination therapy for such patients will save both lives and money... - Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysisAaron S Kesselheim
Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02120, USA
JAMA 300:2514-26. 2008..Use of generic drugs, which are bioequivalent to brand-name drugs, can help contain prescription drug spending. However, there is concern among patients and physicians that brand-name drugs may be clinically superior to generic drugs... - The effect of Medicare Part D coverage on drug use and cost sharing among seniors without prior drug benefitsSebastian Schneeweiss
Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women s Hospital in Boston, Massachusetts, USA
Health Aff (Millwood) 28:w305-16. 2009..Patients reaching the Part D coverage gap (12 percent) experienced a decrease in essential medication use ranging from 5.7 percentage points per month for warfarin to 6.3 percentage points for statins... - Drug company-sponsored patient assistance programs: a viable safety net?Niteesh K Choudhry
Brigham and Women s Hospital BWH, Division of Pharmacoepidemiology and Pharmacoeconomics, in Boston, Massachusetts, USA
Health Aff (Millwood) 28:827-34. 2009..A better understanding of PAPs might clarify their role in improving access to medications, the adequacy of existing public programs, and their impact on cost-effective medication use... - Trends in adherence to secondary prevention medications in elderly post-myocardial infarction patientsNiteesh K Choudhry
Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02120, USA
Pharmacoepidemiol Drug Saf 17:1189-96. 2008..Poor levels of medication adherence for patients with coronary heart disease (CHD) have been documented but it is unclear whether adherence has improved over time... - Free drug samples in the United States: characteristics of pediatric recipients and safety concernsSarah L Cutrona
Department of Medicine, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, USA
Pediatrics 122:736-42. 2008..Free drug samples frequently are given to children. We sought to describe characteristics of free sample recipients, to determine whether samples are given primarily to poor and uninsured children, and to examine potential safety issues... - A practical physicians' guide to the Medicare drug benefit planAlex D Federman
Division of General Internal Medicine, Mount Sinai School of Medicine, Mount Sinai Hospital, New York, New York 10029, USA
Mayo Clin Proc 81:1217-21. 2006..This may, in turn, reduce beneficiaries' out-of-pocket prescription costs, thereby improving patients' access to medications and possibly their medication adherence and health outcomes as well... - The epidemiology of prescriptions abandoned at the pharmacyWilliam H Shrank
Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts 02120, USA
Ann Intern Med 153:633-40. 2010..Understanding the epidemiology and correlates of prescription abandonment may have an important effect on health care quality... - Focus group findings about the influence of culture on communication preferences in end-of-life careWilliam H Shrank
Division of General Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA
J Gen Intern Med 20:703-9. 2005..Little guidance is available for health care providers who try to communicate with patients and their families in a culturally sensitive way about end-of-life care... - Adverse Drug Reactions in Elderly People: A substantial cause of preventable illnessJerry Avorn
Division of Pharmacoepidemiology and Pharmacoeconomics, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02120, USA
BMJ 336:956-7. 2008 - Effect of incentive-based formularies on drug utilization and spendingWilliam H Shrank
N Engl J Med 350:1057. 2004 - Increasing generic drug use in Medicare Part D: the role of governmentHerb Kohl
United States Senator from Wisconsin, Majority Leader, U.S. Senate Special Committee on Aging, 2nd and C St, NE, 330 Hart Senate Office Building, United States Senate, Washington, DC 20510, USA
J Am Geriatr Soc 55:1106-9. 2007 - The quality of obstructive lung disease care for adults in the United States as measured by adherence to recommended processesRichard A Mularski
Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate, WIN 1060, Portland, OR 97227, USA
Chest 130:1844-50. 2006..The extent to which patients with obstructive lung disease receive recommended processes of care is largely unknown. We assessed the quality of care delivered to a national sample of the US population... - A cross-national study of the persistence of antihypertensive medication use in the elderlyBoris L G Van Wijk
Department of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands b l g
J Hypertens 26:145-53. 2008..The aim of this study was to describe and compare patterns of use of antihypertensive drugs in a population of elderly patients in the United States (Pennsylvania), Canada (British Columbia) and the Netherlands...
Research Grants
- An intervention to improve rational prescribing in cardiovascular diseaseWilliam Shrank; Fiscal Year: 2007..End of Abstract) ..