Alyce S. Adams, PhD

People

Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-5921 (phone)
alyce.s.adams@kp.org
Kaiser Permanente Researcher Profiles

Dr. Adams' work has focused on the determinants of suboptimal use of potentially beneficial health care services among disparities populations, including racial differences in medication adherence and the impact of changes in health policy on access to high quality health services and health outcomes for vulnerable patients. Dr. Adams is a member of the Kaiser Permanente Disparities Working Group and the Advisory Committee on Quality for the California Health Families Program.

Current Position(s):

Research Scientist III, Division of Research, Kaiser Permanente Northern California

Section Affiliations:

Associate Director, Health Care Delivery and Policy

Primary Research Interests:

Healthcare Disparities/Vulnerable Populations
Health Services and Policy Research

Studies

Leveraging Machine Learning to Improve Risk Prediction for Chemotherapy Induced Neuropathy

Chemotherapy-associated peripheral neuropathy (CPN) affects nearly 70% of cancer patients. An estimated 30% of cancer survivors have persistent CPN, which can have a devastating impact on their quality of life and functioning. Our objective is to develop and validate a predictive model that will identify those patients who are at high risk of developing severe CPN that can result in their receiving fewer planned chemotherapy cycles. We will focus on two subgroups our preliminary studies suggest have a higher risk for CPN: people who have diabetes or are African American/ Black.

Investigator: Adams, Alyce; Neugebauer, Romain
Funder: National Cancer Institute

Drug Benefit Design and Adherence Disparities in Older Adults

Our prior study examined the impact of one aspect of Medicare Part D, the removal of limits on the number of reimbursable prescriptions per month (drug caps) on racial differences in chronic disease treatment among dual Medicare and Medicaid enrollees with complex medical conditions. Among dual enrollees with diabetes and common comorbidities, white-black treatment gaps that were present at baseline (e.g., lipid lowering therapy, antidepressants) persisted among patients 65 and older) and worsened among women and those 65 and younger. The primary objective of this study is to enhance our understanding of persistent disparities in treatment adherence and the equity effects of changes in drug coverage in order to reduce disparities in treatment adherence among older adults with complex medical conditions.
Investigator: Adams, Alyce
Funder: National Institute on Aging

Improving Outcomes and Care Experience among Dual-Eligible Members

This study will be one of the first to examine the relationship between health-system factors across the continuum of care (pharmacy, hospital, primary care) and health-care quality and outcomes among vulnerable, dual-eligible, managed-care members. In addition, we will use geographically-tagged data on social determinants of health, or neighborhoods where these members live, to identify geographic clusters of patients who are at higher risk for suboptimal health outcomes. Further, we will leverage simulation methods to evaluate the potential impact of addressing these factors on future utilization.
Investigator: Adams, Alyce
Funder: TPMG Delivery Science Projects Program

Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative

The Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative was initiated in 2014 to bridge the Health Care Systems Research Network (HCSRN) with the Older Americans Independence Centers (OAICs, also known as “Pepper Centers”) in order to advance an interdisciplinary research agenda focused on older adults with multiple chronic conditions. The overarching aim of this current project is to build upon AGING’s efforts to create a mature and sustainable infrastructure to advance an interdisciplinary research agenda to improve the care and well-being of these adults.

Investigator: Adams, Alyce
Funder: National Institute on Aging

Predictive Modeling to Aid Clinical Decision-Making and Improve Diabetic Peripheral Neuropathy Outcomes

This 18-month research project will bring together a multidisciplinary team of scientists and clinicians from four Kaiser Permanente regions (Kaiser Permanente Northern California, Kaiser Permanente Colorado, Kaiser Permanente Hawaii, and Kaiser Permanente of the Mid-Atlantic States) to identify patients most likely to benefit from intensive monitoring of diabetic peripheral neuropathy symptoms using predictive modeling strategies. The long-term goal of this study is to improve medical management of diabetic peripheral neuropathy while enhancing both the patient and provider experience and reducing healthcare costs.
Investigator: Adams, Alyce
Funder: Garfield Memorial Fund

Does Free Medicines Coverage Improve Diabetes Self-Care and Outcomes for Diverse Populations?

This is a quasi-experimental longitudinal study to evaluate the impact of Kaiser Permanente Hawaii WellRx — a program intended to engage patients more effectively in their self-care — among a diverse cohort of patients with diabetes. The study evaluates a natural experiment in which select employers and patients were offered zero dollar cost sharing for chronic disease medications. This study will use Kaiser Permanente Hawaii data only.
Investigator: Adams, Alyce
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Balancing Treatment Outcomes and Medication Burden among Patients with Symptomatic Diabetic Peripheral Neuropathy

This project is a continuation of a study we recently conducted to identify and prioritize treatment outcomes of relevance to patients with diabetic peripheral neuropathy (DPN). DPN affects 30% to 50% of all adults with diabetes and symptoms such as pain, tingling, numbness or a burning sensation in the extremities can be sudden and severe. Currently, only two prescription medications are approved for treatment of DPN symptoms, though many more are routinely used in practice. Clinical trials suggest that commonly used therapies have similar efficacy with respect to pain relief. However, side effects are common and little is known about the relative efficacy of these medications in addressing other patient-valued outcomes (e.g., quality of life). The goal of the proposal is to evaluate whether a clinical decision aid that includes information on patient treatment preferences can improve treatment persistence and outcomes that are important to patients.
Investigator: Adams, Alyce
Funder: Patient-Centered Outcomes Research Institute

Highlighted Publications

The Diabetes Telephone Study; Design and challenges of a pragmatic cluster randomized trial to improve diabetic peripheral neuropathy treatment

Author(s): Adams AS; Bayliss EA; Schmittdiel JA; Altschuler A; Dyer W; Neugebauer R; Jaffe M; Young JD; Kim E; Grant RW; Diabetes Telephone Study Team

Clin Trials. 2016 Mar 31.

Current Position(s):

Section Affiliations:

Primary Research Interests:

Studies

Leveraging Machine Learning to Improve Risk Prediction for Chemotherapy Induced Neuropathy

Drug Benefit Design and Adherence Disparities in Older Adults

Improving Outcomes and Care Experience among Dual-Eligible Members

Advancing Geriatrics Infrastructure and Network Growth (AGING) Initiative

Predictive Modeling to Aid Clinical Decision-Making and Improve Diabetic Peripheral Neuropathy Outcomes

Does Free Medicines Coverage Improve Diabetes Self-Care and Outcomes for Diverse Populations?

Balancing Treatment Outcomes and Medication Burden among Patients with Symptomatic Diabetic Peripheral Neuropathy

Highlighted Publications

The Diabetes Telephone Study; Design and challenges of a pragmatic cluster randomized trial to improve diabetic peripheral neuropathy treatment

Effects of Eliminating Drug Caps on Racial Differences in Antidepressant Use Among Dual Enrollees With Diabetes and Depression

Changes in Use of Lipid-lowering Medications Among Black and White Dual Enrollees With Diabetes Transitioning From Medicaid to Medicare Part D Drug Coverage

Health System Factors and Antihypertensive Adherence in a Racially and Ethnically Diverse Cohort of New Users

Medication adherence and racial differences in A1C control

Publications

Study protocol: Using peer support to aid in prevention and treatment in prediabetes (UPSTART)

Exploiting nonsystematic covariate monitoring to broaden the scope of evidence about the causal effects of adaptive treatment strategies

Preventing Diabetes in High-Risk Patients: Time for a System-Level Approach to Disease Prevention

Targeted learning with daily EHR data

Disparities in knowledge and use of tobacco treatment among smokers in California following healthcare reform

Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial

Clinical Response to Real-Time Patient-Reported Diabetic Peripheral Neuropathy Symptoms

Examining the role of access to care: Racial/ethnic differences in receipt of resection for early-stage non-small cell lung cancer among integrated system members and non-members

Automated symptom and treatment side effect monitoring for improved quality of life among adults with diabetic peripheral neuropathy in primary care: a pragmatic, cluster, randomized, controlled trial.

Evaluating the Impact of Eliminating Copayments for Tobacco Cessation Pharmacotherapy

Depression in type 1 diabetes and risk of dementia

Disparities in Prostate, Lung, Breast, and Colorectal Cancer Survival and Comorbidity Status among Urban American Indians and Alaskan Natives

The Delivery Science Rapid Analysis Program: A Research and Operational Partnership at Kaiser Permanente Northern California

Effects of Transitioning to Medicare Part D on Access to Drugs for Medical Conditions among Dual Enrollees with Cancer

Effect of Out-of-Pocket Cost on Medication Initiation, Adherence, and Persistence among Patients with Type 2 Diabetes: The Diabetes Study of Northern California (DISTANCE)

Population Health Management for Diabetes: Health Care System-Level Approaches for Improving Quality and Addressing Disparities

Predicting Adherence and Persistence with Oral Bisphosphonate Therapy in an Integrated Health Care Delivery System

Depressive symptoms and adherence to cardiometabolic therapies across phases of treatment among adults with diabetes: the Diabetes Study of Northern California (DISTANCE)

Association of the Affordable Care Act With Smoking and Tobacco Treatment Utilization Among Adults Newly Enrolled in Health Care

Identification of the joint effect of a dynamic treatment intervention and a stochastic monitoring intervention under the no direct effect assumption

Overcoming barriers to diabetic polyneuropathy management in primary care

A Learning Behavioral Health Care System; Opportunities to Enhance Research

Improved Perinatal Depression Screening, Treatment, and Outcomes With a Universal Obstetric Program

Communication Barriers and the Clinical Recognition of Diabetic Peripheral Neuropathy in a Diverse Cohort of Adults: The DISTANCE Study

The Diabetes Telephone Study; Design and challenges of a pragmatic cluster randomized trial to improve diabetic peripheral neuropathy treatment

Pre-visit prioritization for complex patients with Diabetes; Randomized Trial Design and Implementation within an Integrated Health Care system

An algorithm to identify medication nonpersistence using electronic pharmacy databases

Patient reported outcomes for diabetic peripheral neuropathy

Ethnic Differences in Geriatric Conditions and Diabetes Complications Among Older, Insured Adults With Diabetes; The Diabetes and Aging Study

Impact of a Pharmacy Benefit Change on New Use of Mail Order Pharmacy among Diabetes Patients; The Diabetes Study of Northern California (DISTANCE)

Effects of Eliminating Drug Caps on Racial Differences in Antidepressant Use Among Dual Enrollees With Diabetes and Depression

Diabetes care and outcomes for American Indians and Alaska natives in commercial integrated delivery systems; a SUrveillance, PREvention, and ManagEment of Diabetes Mellitus (SUPREME-DM) Study

Changes in Use of Lipid-lowering Medications Among Black and White Dual Enrollees With Diabetes Transitioning From Medicaid to Medicare Part D Drug Coverage

Associations Between Antidepressant Adherence and Shared Decision-Making, Patient-Provider Trust, and Communication Among Adults with Diabetes; Diabetes Study of Northern California (DISTANCE)

Initial Persistence With Antihypertensive Therapies Is Associated With Depression Treatment Persistence, But Not Depression

Effects of Medicare Part D on Guideline-Concordant Pharmacotherapy for Bipolar I Disorder Among Dual Beneficiaries

Establishing visit priorities for complex patients; A summary of the literature and conceptual model to guide innovative interventions

Differences in the clinical recognition of depression in diabetes patients; the diabetes study of northern california (DISTANCE)

Health Literacy and Antidepressant Medication Adherence Among Adults with Diabetes; The Diabetes Study of Northern California (DISTANCE)

The top patient safety strategies that can be encouraged for adoption now

Health System Factors and Antihypertensive Adherence in a Racially and Ethnically Diverse Cohort of New Users

Health-Plan and Employer-Based Wellness Programs to Reduce Diabetes Risk; The Kaiser Permanente Northern California NEXT-D Study

Elevated Rates of Diabetes in Pacific Islanders and Asian Subgroups; The Diabetes Study of Northern California (DISTANCE)

Symptom Burden of Adults with Type 2 Diabetes Across the Disease Course; Diabetes & Aging Study

Medicare part d and changes in prescription drug use and cost burden; national estimates for the medicare population, 2000 to 2007

Racial and ethnic disparities in postpartum depression care among low-income women

Advancing the science of patient safety

Adherence to laboratory test requests by patients with diabetes; the Diabetes Study of Northern California (DISTANCE)

Heterogeneity of diabetes outcomes among asians and pacific islanders in the US; the diabetes study of northern california (DISTANCE)

New Jersey's efforts to improve postpartum depression care did not change treatment patterns for women on medicaid

Association between prior authorization for medications and health service use by Medicaid patients with bipolar disorder

Impact of prior authorization on the use and costs of lipid-lowering medications among Michigan and Indiana dual enrollees in Medicaid and Medicare; results of a longitudinal, population-based study

Use of well-child visits in high-deductible health plans

Primary non-adherence to prescribed medications

Impact of two Medicaid prior-authorization policies on antihypertensive use and costs among Michigan and Indiana residents dually enrolled in Medicaid and Medicare; results of a longitudinal, population-based study

Unintended impacts of a Medicaid prior authorization policy on access to medications for bipolar illness

A new measure of medication affordability

The population-level impacts of a national health insurance program and franchise midwife clinics on achievement of prenatal and delivery care standards in the Philippines

Bisphenol A levels in blood and urine in a Chinese population and the personal factors affecting the levels

Prior authorization for antidepressants in Medicaid; effects among disabled dual enrollees

Racial differences in long-term adherence to oral antidiabetic drug therapy; a longitudinal cohort study

Medication adherence and racial differences in A1C control