# The HIV and Alcohol Research center focused on Polypharmacy (HARP)

> **NIH NIH P01** · YALE UNIVERSITY · 2022 · $1,203,656

## Abstract

HARP OVERALL PROJECT SUMMARY
The goal of the HIV and Alcohol Research center focused on Polypharmacy (HARP) is to design and
implement effective personalized interventions for people aging with HIV (PAH) experiencing medical harm
from unhealthy alcohol use (at risk and Alcohol Use Disorder [AUD]) and polypharmacy (5+ medications).
Using large scale, national Veterans Healthcare Administration Electronic Health Record data (EHR data), we
have shown strong independent, dose-response, associations between polypharmacy (medication count and
A-PIMS), alcohol use, and adverse health outcomes. In HARP Project 1, we further explore alcohol and
polypharmacy (AP) risks using a direct alcohol biomarker (Phosphatidylethanol [PEth]), considering genetic
liability, and exploring associations with decompensated liver cirrhosis as a manifestation of alcohol-associated
liver disease (AALD). Polypharmacy and genetic liability also complicate selection of treatment for AUD. In
HARP Project 2, we use genetic liability and real-world data to identify and evaluate candidate medications in
the context of polypharmacy. Further, AP risks, especially genetic liability, are complex and challenging to
summarize. Both summarizing effects of multiple risk factors and using genetic data to identify medications for
repurposing requires large-scale, real-world data, high performance computing and sophisticated analytics.
With support from our Administrative/Data Analytic (ADA) Core, the Department of Energy (DOE), an extended
VA family of EHR cohorts (VACo Family), and an expanded network of experts, we are uniquely poised to
harness “big” data to personalize AP risks for PAH and evaluate medications for AUD. Finally, effective
communication of AP risk messages needs to be integrated into a comprehensive, theory-based behavior
change intervention. We have assembled a Risk Communication Core (RCC) of experts to facilitate risk
communication and motivational interviewing (MI) in our pilot intervention studies. The core includes Dr. Jeffrey
Fisher, co-developer of the Information-Motivation-Behavioral Skills (IMB) model of health behavior change. In
collaboration with Dr. Fisher, this core will guide our application of the IMB-MI model to communicate
personalized risk and other elements required for health behavior change in a linked series of pharmacist-
delivered pilot interventions. Project 1 pilots will compare patient’s responses to AP risk messages (employing
different measures of exposure and outcomes) delivered in the larger context of an IMB-MI intervention for
PAH who are at risk drinkers; Project 2 pilots will incorporate lessons learned in Project 1 and adapt the IMB-
MI intervention to target PAH with AUD, adding a candidate repurposed medication for AUD.

## Key facts

- **NIH application ID:** 10486103
- **Project number:** 5P01AA029545-02
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Amy Caroline Justice
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,203,656
- **Award type:** 5
- **Project period:** 2021-09-10 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10486103

## Citation

> US National Institutes of Health, RePORTER application 10486103, The HIV and Alcohol Research center focused on Polypharmacy (HARP) (5P01AA029545-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10486103. Licensed CC0.

---

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