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Carolyn Thorpe

Associate Professor

Carolyn Thorpe, Ph.D., MPH

Associate Professor

(919) 843-9834
Kerr Hall, , , Chapel Hill, NC, 27599, , Kerr Hall, 301 Pharmacy Lane, , Chapel Hill, NC, 27599

Dr. Thorpe is a tenured Associate Professor in the Division of Pharmaceutical Outcomes and Policy. She holds a joint appointment as Core Investigator with the Veterans Affairs Pittsburgh Healthcare System’s Center for Health Equity Research and Promotion (CHERP). As a pharmaceutical health services researcher with a focus on geriatric populations, her federally-funded research program aims to improve the health of older, complex patients with multiple chronic conditions, through studies on the quality and safety of prescribing, as well as medication adherence. Her interests are driven broadly by a desire to improve treatment decisions, care delivery, and quality of life for older persons who are faced with the demands of managing multiple conditions simultaneously, often in the context of diminished capacity (e.g., cognitive impairment) and a lacking evidence base regarding optimal treatment. A current focus of this work aims to elucidate real-world patterns of deprescribing of medications with increased risks and/or reduced benefits in older adults with limited life expectancy and/or advanced dementia and the impact of deprescribing on patient-centered outcomes. Much of this work is highly policy-relevant, as it is aimed at improving care and outcomes for two of the largest populations of older adults who use federal health benefits: 1) U.S. Military Veterans seeking healthcare in the Department of Veterans Affairs (VA), and 2) Medicare fee-for-service (FFS) beneficiaries. In addition, because older patients with multiple chronic conditions often rely on loved ones to help with day-to-day illness management and accessing medical care, caregiving and dyadic illness management have been a cross-cutting theme of this work.

Methodologically, Dr. Thorpe has expertise in a secondary analysis of real-world healthcare data (e.g., medical claims, prescription drug records, electronic health records, federal surveys) and observational study designs to compare the effectiveness and safety of different treatment options. She also is well-versed in scale development, survey research, and qualitative methods, and uses a combination of quantitative and qualitative approaches in her studies.

Dr. Thorpe is a highly active research mentor, and over the past decade has served as the primary or co-mentor of many graduate students, postdoctoral fellows, junior faculty, pharmacy students, and residents engaged in research. She also currently serves as Co-Director of the VA Postdoctoral Pharmacy Fellowship in Medication Safety and Pharmacy Outcomes, which is a collaboration of CHERP and the national VA Center for Medication Safety within VA Pharmacy Benefits Management (PBM) Services. This fellowship is designed to train pharmacists in health services research and quality improvement aimed at improving medication safety in the Veterans Affairs (VA) healthcare system.

  • University of Michigan, B.A. in Psychology, 1998
  • George Washington University, M.P.H. with a concentration in Health Promotion, 2001
  • University of North Carolina at Chapel Hill, Ph.D. in Health Behavior, 2006
  • Post-doctoral Fellowship in Health Services Research, Center for Health Services Research in Primary Care, Durham VA Medical Center, 2006-2008

Current Research Areas & Recent Publications (selected from over 100 total)

*Indicates authors who were students and trainees under my direction at the time of the project

  • Real-world patterns and determinants of deprescribing of medications of questionable benefit in geriatric populations
    • *Niznik JD, *Hunnicutt JN, Zhao X, Mor MK, Sileanu F, Aspinall SL, *Springer SP, Ersek MJ, Gellad WF, *Schleiden LJ, Hanlon JT, Thorpe JM, Thorpe CT. Deintensification of diabetes medications among Veterans at the end-of-life in VA nursing homes. Journal of the American Geriatrics Society (in press).
    • *Springer SP, Mor MK, Sileanu F, Zhao X, Aspinall SL, Ersek M, *Niznik JD, Hanlon JT, *Schleiden LJ, *Hunnicutt J, Gellad WF, Thorpe JM, Thorpe CT. Incidence and predictors of aspirin discontinuation in older Veteran nursing home residents at end-of-life. Journal of the American Geriatrics Society (in press).
    • *Niznik J, Zhao X, He M, Aspinall SL, Hanlon JT, Nace D, Thorpe JM, Thorpe CT. Factors associated with deprescribing AChEIs in older NH residents with severe dementia. Journal of the American Geriatrics Society 2019 Jun 4 [epub ahead of print].
    • Aspinall SL, Hanlon JT, *Niznik JD, *Springer SP, Thorpe CT. Deprescribing in older nursing home patients: Focus on innovative composite measures for dosage deintensification. Innovation in Aging 2018; 1(2).


  • Patient-centered outcomes of deprescribing of medications of questionable benefit
    • *Niznik JD, Zhao X, He M, Aspinall SL, Hanlon JT, Nace D, Thorpe JM, Thorpe CT. Impact of deprescribing AChEIs on aggressive behaviors and antipsychotic prescribing. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association (in press).
    • *Niznik JD, Zhao X, He M, Aspinall SL, Hanlon JT, Hanson LC, Nace D, Thorpe JM, Thorpe CT. Risk for health events after deprescribing AChEIs in nursing home residents with severe dementia. Journal of the American Geriatrics Society (in press).
    • *Vu M, *Schleiden LJ, *Harlan ML, Thorpe CT. Hypertension management in nursing homes: Review of evidence and considerations for care. Current Hypertension Reports (in press).
    • Pruskowski J, *Springer S, Thorpe CT, Klein-Fedyshin M, Handler SM. Does deprescribing improve quality of life: A systematic review of the literature. Drugs & Aging 2019 Oct 09 [epub ahead of print].


  • Dual VA & non-VA health system use by Veterans
    • Thorpe CT, Gellad WF, Mor MK, Cashy JP, Pleis JR, Van Houtven CH, Schleiden LJ, Hanlon JT, *Niznik JD, *Carico RL, Good CB, Thorpe JM. Effect of dual use of Veterans Affairs (VA) and Medicare Part D drug benefits on antihypertensive medication supply in a national cohort of Veterans with dementia. Health Services Research 2018 53(Suppl 3): 5375-5401.
    • Thorpe JM, Thorpe CT, *Carico RL, Cashy JP, Gellad WF, *Schleiden LJ, Van Houtven CH. Association between Dual Use of Department of Veterans Affairs and Medicare Drug Benefits and Potentially Unsafe Prescribing. JAMA Internal Medicine 2019 July 22 [epub ahead of print].
    • Bixler FR, Radomski TR, Zickmund SL, Roman KM, Hausmann LRM, Thorpe CT, Hale JA, Sileanu FE, Gellad WF. Primary Care Physicians’ Perspectives on Veterans Who Obtain Prescription Opioids from Multiple Healthcare Systems. Journal of Opioid Management 2019 15(3):183-191.
    • *Moyo P, Zhao X, Thorpe CT, Thorpe JM, Sileanu F, Cashy JP, Hale JA, Mor MK, Radomski TR, Donohue JM, Hausmann LRM, Hanlon JT, Good CB, Fine MJ, Gellad WF. Dual receipt of prescription opioids from VA and Medicare Part D and prescription opioid overdose death among Veterans: A nested case-control study. Annals of Internal Medicine 2019 Mar 12 [epub ahead of print].


  • Conceptualization and measurement of medication adherence
    • Kronish IM, Thorpe CT, Voils CV. Measuring the multiple domains of medication nonadherence: Findings from a Delphi survey of adherence experts. Translational Behavioral Medicine 2019 Oct 03 [epub ahead of print].
    • Voils CI, King H, Blalock DV, Thorpe CT, Kronish I, Reeve BB, Boatwright C, Gellad ZF. Content validity and reliability of a self-report measure of medication nonadherence in hepatitis C treatment. Digestive Diseases and Sciences 2019 Apr 29 [epub ahead of print].
    • Gellad WF, Thorpe CT, Steiner JF, Voils CI. The myths of medication adherence. Pharmaceoepidemiology and Drug Safety 2017;26(12):1437-1441.


  • Healthcare utilization, quality of care, and illness management in patients with ANCA small vessel vasculitis, a rare autoimmune disease
    • *Nguyen J, Roberts C, Thorpe CT, Thorpe J, Hogan S, McGregor J, Geryk L, Carpenter D. Economic and Objective Burden of Caregiving on Informal Caregivers of Patients with Systemic Vasculitis. Musculoskeletal Care 2019 17(2): 282-287.
    • Thorpe CT, Thorpe JM, Jiang T, *Atkinson D, Kang Y, Schleiden LJ, Carpenter DM, McGregor JG, Hogan SL. Healthcare utilization and expenditures for United States Medicare beneficiaries with systemic vasculitis. Seminars in Arthritis and Rheumatism 2018;47(4):507-519. PMCID: PMC5743622.
  • Thorpe CT, Devellis RF, Lewis MA, Blalock SJ, Hogan SL, DeVellis BM. Development and initial evaluation of a measure of self-management for adults living with ANCA-associated small vessel vasculitis. Arthritis Rheum. 2007 Oct 15;57(7):1296-302. PMID: 17907222; PMCID: PMC4049533.




Project Number: R21AI160606 (PI: C. Thorpe)

Title: Use and effectiveness of infection prophylaxis strategies in a national cohort of patients with ANCA vasculitis

Source: National Institute of Allergy and Infectious Diseases (NIAID)

Projected Dates: 02/13/2021 – 01/31/2023

Role: Principal Investigator


Project Number: IIR 19-089 (PI: C. Thorpe)

Title: Use and costs of low-value health services by Veterans in VA and non-VA settings

Source: Department of Veterans Affairs, Health Services Research & Development

Projected Dates: 03/01/2020-02/28/2023

Role: Principal Investigator


Project Number: K08 AG071794 (PI: Niznik)

Title: Deprescribing bisphosphonates in older nursing home residents with dementia

Source: National Institute on Aging (NIA)
Projected Dates: 04/01/2021-03/31/2026

Role: Primary Mentor


Project Number: 5K23 AG061217-02 (PI: Radomski)

Title: The development, application, and validation of a patient-centered metric of low-value prescribing in older adults

Source: National Institute on Aging (NIA)
Projected Dates: 09/01/2019-08/31/2023

Role: Co-mentor


Project Number: IIR 19-106 (PI: J. Thorpe)

Title: Outpatient palliative care and prescribing safety and quality at end-of-life

Source: Department of Veterans Affairs, Health Services Research & Development

Projected Dates: 08/01/2020-01/31/2024

Role: Co-Investigator


Project Number: PEC 20-169 (PI: Gellad)

Title: Dual use of medication (DUAL) Partnered Evaluation Initiative

Source: Department of Veterans Affairs, Quality Enhancement Research Initiative

Projected Dates: 04/01/2021-03/31/2024

Role: Co-Investigator


Project Number: 1I21RX003732-01A1 (PI: Bramoweth) – Intent-to-Fund Issued; Just-in-Time pending

Title: SEdative-hypnotic deprescribing assisted by a technology-driven insomnia interVEntion (SEDATIVE)

Source: Department of Veterans Affairs, Rehabilitation Research & Development

Projected Dates: 1/1/2022 – 12/31/2023

Role: Co-investigator

Recently Completed (selected)

Project Number: IIR 14-306 (PI: C. Thorpe)

Title: De-intensifying unnecessary medications in VA CLC residents nearing end of life

Source: Department of Veterans Affairs, Health Services Research & Development

Dates: 5/1/2016-6/30/2021

Role: Principal Investigator


Project Number: N/A (Co-PIs: C. Thorpe and Aspinall)

Title: De-prescribing of anti-dementia medications

Source: The Patrick and Catherine Weldon Donaghue Foundation

Dates: 9/1/2018-10/31/2019

Role: Co-Principal Investigator