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Carolyn Thorpe

Associate Professor

Carolyn Thorpe, Ph.D., MPH

Associate Professor


PHONE
(919) 843-9834
EMAIL
ckalino@email.unc.edu
ADDRESS
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. 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 day-to-day illness management for older persons who are faced with the demands of managing multiple conditions simultaneously, often in 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 has been a cross-cutting theme of this work.

 

Methodologically, Dr. Thorpe has expertise in secondary analysis of existing administrative and clinical 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 survey research, scale development, and qualitative methods, and often 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 10 graduate students, 9 postdoctoral fellows, 5 junior faculty, and numerous 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 and is designed to train pharmacists in research and quality improvement.

  • University of Michigan, B.A. in Psychology, 1998
  • George Washington University, M.P.H. with concentration in Health Promotion, 2001
  • University of North Carolina at Chapel Hill, PhD 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.

 

Grants

Current

Project Number: IIR 19-089 – pending final JIT approval (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

Total Direct Costs: $1,198,320

Projected Dates: 02/01/2020-01/31/2022

Role: Principal Investigator

 

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 (HSR&D)

Total Direct Costs: $1,024,629

Dates: 5/1/2016-4/30/2020

Role: Principal Investigator

 

Project Number: NRI 15-150 (PI: DiNardo)

Title: Effects of a mindfulness intervention delivered with diabetes education on diabetes-related outcomes in Veterans

Source: Department of Veterans Affairs, Nursing Research Initiative (NRI)

Total Direct Costs: $1,070,712

Dates: 6/1/2016-5/31/2020

Role: Co-investigator

 

Mechanism: K23, Mentored Patient-Oriented Research Career Development Award (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

Total Direct Costs: $877,500

Dates: 09/01/2019 – 08/31/2023

Role: Co-mentor

 

Project Number: N/A (PI: E. Roberts)

Title: Understanding the impacts of Choice on Veterans’ Care: Assembling novel data for a quasi-experimental evaluation

Source: Department of Veterans Affairs, VA Pittsburgh Healthcare System

Total Direct Costs: $25,000

Dates: 10/01/2019 – 09/30/2020

Role: Co-investigator

 

Project Number: N/A (PI: Makaroun)

Title: Describing characteristics and identifying potential risk factors for older Veterans who may be experiencing abuse and neglect

Source: Department of Veterans Affairs, VA Pittsburgh Healthcare System

Total Direct Costs: $39,320

Dates: 10/01/2018 – 12/31/2019

Role : Co-mentor

 

Recently Completed (selected)

 

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

Total Direct Costs (Sub-award only): $125,672

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

Role: Co-Principal Investigator

 

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

Title: De-prescribing of anti-dementia medications

Source: The Pittsburgh Claude D. Pepper Older Americans Independence Center

Total Direct Costs: $24,897

Dates: 2/02/2018-8/31/2018

Role: Co-Principal Investigator

 

Project Number: N/A (PI: Radomski)

Title: Development of a patient-centered metric of low-value prescribing in older adults

Source: University of Pittsburgh Pepper Center Pilot Grant

Total Direct Costs: $12,500

Dates: 02/01/2018 – 01/31/2019

Role: Co-mentor

 

Project Number: IIR 14-297 (PI: Gellad)

Title: Safety of Opioid Use Among Veterans Receiving Care in Multiple Health Systems

Source: Department of Veterans Affairs, Health Services Research & Development (HSR&D)

Total Direct Costs: $1,047,615
Dates: 2/1/2015-12/31/2018

Role: Co-investigator

 

Project Number: IIR 12-379 (PI: J. Thorpe)

Title: Dual use of VA/Medicare Part D and unsafe prescribing in Veterans with dementia

Source: Department of Veterans Affairs, Health Services Research & Development (HSR&D)

Total Direct Costs: $920,000

Dates: 6/1/2014-4/30/2017

Role: Co-investigator

 

Project Number: N/A (PI: Hanlon)

Title: Cumulative CNS Medication Dosage and Serious Fall Injuries

Source: The Patrick and Catherine Weldon Donaghue Foundation

Total Direct Costs: $105,216

Dates: 1/1/2015-12/31/2016

Role: Co-investigator

 

Project Number: N/A (PI: C. Thorpe)

Title: Impact of healthcare utilization and informal caregiving for primary systemic vasculitis: A national perspective

Source: Vasculitis Foundation

Total Direct Costs: $99,920

Dates: 12/1/13-05/31/16

Role: Principal Investigator

 

Project Number: VCA 15-425 (PI: Zickmund)

Title: Differences in Satisfaction with Choice: Laying the Foundation for the Evaluation of the CHOICE Act

Source: Department of Veterans Affairs, Quality Enhancement Research Initiative (QUERI)

Total Direct Costs: $277,449

Dates: 4/1/2015-9/30/2015

Role: Co-investigator

 

Project Number: N/A (PI: Good)

Title: PBM/VA Center for Medication Safety Quality Improvement Initiative

Source: Department of Veterans Affairs, Pharmacy Benefits Management/Center for Medication Safety

Total Direct Costs: $25,886

Dates: 11/1/2014-9/30/2015

Role: Co-investigator