Pharmacoepidemiology = pharmacology + epidemiology
Pharmacoepidemiology involves studying the utilizaiton, safety, and effectiveness of medications at a population level.
Our team strives to understand what determines both the benefits and adverse events of drug therapy, with a focus on diabetes management.
Knowledge Synthesis Studies
Systematic reviews and meta-analysis are important knowledge synthesis techniques to summarize the curent state of knowledge around a particular clinical question. From overviews of reviews to network meta-analysis, the Gamble lab has conducted several knowledge syntheses within the space of pharmacotherapeutic management of diabetes including the safety of effectiveness of incretin-based therapies, cardiovascular risks of insulin, and the comparative safety of sodium glucose co-transporter-2 inhibitors.
Drug Utilization Studies
Understanding the frequency and patterns at which a drug is used on the market aids in understanding the extent of population exposure to various pharmacotherapeutic agents. Furthermore, drug utilization studies can be used to measure the impact of various policies on drug use and health outcomes.
Drug Safety Studies
Measuring the risk of potential harms associated with using medications is one of the most important contributions of a pharmacoepidemiologic study. The Gamble Lab typically uses data from everyday encounters with the health system such as physician visits, pharmacy records, hospital discharge records, and vital statistics records to create study populations and analyze relationships between drug exposure and potential harms from medications.
Drug Effectiveness Studies
The Gamble Lab also studies the potential benefits of medications using epidemiologic methods. Observational drug effect studies are inherently challenged in that potential confounding variables may unknowingly affect the drug-outcome association of interest. Confounding by the reason for a drug (i.e., indication) is a major hurdle to overcome when studying drug effectiveness using non-randomized study designs. Advanced study design and statistical analysis are used to combat a variety of potential sources of confounding and bias.
In situations where there is not a clear benefit of using a medication due to potential serious or frequent adverse effects, a systematic benefit-risk assessment may be helfpul for making medical decisions. The Gamble Lab explores methods in benefit-risk assessment, in particular, those that integrate patient preferences.