# Dual Use of Medications (DUAL) Partnered Evaluation Initiative

> **NIH VA I50** · VETERANS HEALTH ADMINISTRATION · 2021 · —

## Abstract

The VA Center for Medication Safety (VAMedSAFE) is charged with improving the safety of medication use for
Veterans. VAMedSAFE’s interventions address the most serious, prevalent, and high-priority health conditions
among Veterans, and yet they have a key limitation – they cannot account for medications received by
Veterans outside VA. Over 80% of VA enrollees have access to medications through other forms of health
insurance, including 50% with Medicare. There is strong evidence that receiving medications from multiple
health systems poses serious health risks. The inability to integrate non-VA prescriptions into VA medication
surveillance efforts has greatly diminished VA’s capacity to ensure safe prescribing to Veterans.
Driven by this evidence, VA signed a groundbreaking agreement with the Centers for Medicare & Medicaid
Services (CMS) to integrate CMS data on prescriptions filled by Veterans in Medicare into VAMedSAFE’s
ongoing safety surveillance activities – something VA has never before been able to do. By the end of calendar
year 2020, VAMedSAFE will have received and cleaned CMS data on dispensed Medicare prescriptions for all
enrolled Veterans and will integrate these data into their ongoing medication surveillance activities.
The objective of our proposed Dual Use of Medications (DUAL) Partnered Evaluation Initiative is to aid
VAMedSAFE in developing and evaluating the roll-out of new quality enhancement tools using these combined
CMS/VA data. Our evaluation has three aims, with the first aim split into two sub-aims. In Aim 1, we will work
with VAMedSAFE to formatively evaluate the types of medications to prioritize when integrating CMS
prescription data into their quality enhancement tools. Aim 1a will quantify how the integration of CMS
prescription data could impact exposure measurement (e.g., number of patients identified as incident
medication users) and outcomes (e.g., number of patients with a medication-related adverse event) for each
ongoing VAMedSAFE surveillance program. Aim 1b will identify high-impact targets for new VA drug safety
initiatives using CMS/VA data, using both quantitative and qualitative analyses. We will query the CMS/VA
data to identify broad drug classes (e.g., hypoglycemics, opioids) that are frequently duplicated or overlapping
between CMS and VA. Then, we will convene two interdisciplinary focus groups with key stakeholders to
identify additional potential high-impact drug targets for future interventions using the CMS/VA data. In Aim 2,
we will evaluate end users’ experiences with the first integration of CMS data into a VAMedSAFE drug safety
dashboard focusing on direct-acting oral anticoagulant safety. Guided by the Practical, Robust Implementation
and Sustainability Model (PRISM), we will conduct telephone interviews with end users of the dashboard (e.g.,
pharmacy directors, academic detailers, clinicians) to identify implementation barriers and facilitators and learn
about their experiences receiv...

## Key facts

- **NIH application ID:** 10181835
- **Project number:** 1I50HX003183-01A1
- **Recipient organization:** VETERANS HEALTH ADMINISTRATION
- **Principal Investigator:** Walid F. Gellad
- **Activity code:** I50 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2021-01-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10181835

## Citation

> US National Institutes of Health, RePORTER application 10181835, Dual Use of Medications (DUAL) Partnered Evaluation Initiative (1I50HX003183-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10181835. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
