Ira Wilson, MD, MSc
Health Services, Policy & Practice
Dr. Wilson is interested in how structural features of healthcare systems affect the interactions between physicians and patients, and how those interactions in turn affect patients' health outcomes. To study these relationships he has studied patients with chronic conditions such as the elderly, persons with depression, and persons with HIV. Recently he his research has focused on understanding and improving the quality of medication prescribing and medication management.
BiographyDr. Wilson graduated from Harvard College with a BA in Social Studies. He worked as Director of the Adolescent Center of Rincon, Puerto Rico for several years before returning to Boston to attending medical school. He graduated from Harvard Medical School in 1987, and completed a residency in Internal Medicine (Primary Care Pathway) at Beth Israel in Boston, MA. Dr. Wilson was Chief Medical Resident at Beth Israel and a fellow in the Harvard General Medicine Program. In 1993 he joined the faculty at Tufts Medical Center where he rose to the rank of Professor in 2006. In 2010 he moved to Brown to become Chair of the Department of Health Services, Policy & Practice.
Research DescriptionDr. Wilson is interested in how structural features of healthcare systems affect interactions between physicians and patients, and how those interactions in turn affect patients' health outcomes. In recent years his research has increasingly focused on patients' adherence with prescription medications as an important example of these relationships. The long-term objective of this research is to improve the diagnosis and treatment of medication adherence problems in persons with HIV and other chronic illnesses. To accomplish this, Dr. Wilson's research focuses on physicians' communication skills, on physicians' practice environments, and on system-level factors that can support physicians and improve the quality of therapeutic drug management. This research employs a wide variety of methods, including qualitative research, analysis of observational data, and randomized trials of interventions.
For example, in collaboration with other researchers, Dr. Wilson has developed a new method to describe and analyze physician-patient interactions called the General Medical Interaction Analysis System (GMIAS). One of the innovations of the GMIAS is that it is the first system to code and analyze physician-patient interactions that focuses on medication adherence. While work to date with the GMIAS has focused on medication adherence, the system is designed to be a tool that is broadly applicable to studies of physician-patient communication during office visits. A number of grants have used the GMIAS, including a current project that examines whether differences in physician-patient communication can contribute to explaining racial and ethnic disparities in HIV care.
Other currently active projects related to medication adherence include 1) a grant that will use cognitive interviewing of patients taking HIV antiretroviral medications to develop new questionnaire items that improve the accuracy of self-reports of medication adherence, 2) a randomized trial of an intensive intervention to improve HIV physicians' adherence counseling skills, and 3) a study funded by the American Recovery and Reinvestment Act of 2009 to examine whether a web-based, physician-focused intervention grounded in behavioral economic theory can improve patients' medication adherence. In conducting this research, Dr. Wilson collaborates with scientists from a wide variety of disciplines, including biostatistics, epidemiology, psychology, sociology, and economics.
Grants and AwardsDr. Wilson was the recipient of a Picker/Commonwealth Scholar's Award, and was selected to be a Robert Wood Johnson Generalist Physician Faculty Scholar. He was awarded a Tufts University School of Medicine Excellence in Teaching Award on four occasions.
AffiliationsMassachusetts Medical Society
Society for General Internal Medicine
American College of Physicians, Associate
Academy for Health Services Research
International Society for Pharmacoeconomic and Outcomes Research
International Association of Physicians in AIDS Care
Funded Research1R01 MH 083595-01A1 Wilson (PI) 7/1/08-6/30/12(NCE)
Analyzing Patient-Provider Communication to Understand Disparities in HIV Care.
This project will use a new method to analyze audiotapes of routine office visits to understand how patient-provider dialogue differs by race and ethnicity.
3R01 NH 083595-02S1 Wilson (PI) 11/1/10-6/30/12 (NCE)
Analyzing Patient-Provider Communication to Understand Disparities in HIV Care
The proposed research is relevant to public health because identifying the features and characteristics of patient-provider interactions that are associated with optimal patient outcomes is a key step in efforts to improving the quality and safety of our healthcare system.
2K24 MH 092242-06 Wilson (PI) 9/30/10-6/30/15
Improving the Diagnosis and Treatment of Medication Adherence Problems in HIV
To improve adherence to prescribed medication regimens and thereby long-term health outcomes of persons with chronic conditions.
5 R01 MH 078773 Liu (PI) 6/1/07-5/21/12
Multi-Site Collaborative Study for Adherence Virologic and Clinical Outcomes.
This 14-site study is examining the impact of antiretroviral medication adherence (assessed by electronic drug monitoring), on a variety of clinical outcomes.
2P30AI042853 Carpenter (PI) 7/1/07-6/30/12
Lifespan/Tufts/Brown Center for AIDS Research (CFAR)
Role: Core Co-Director, Developmental Core
R34 MH 089279 Beach and Laws (Dual PIs) 8/13/10-4/30/12
Improving ARV Adherence through Enhancement of HIV Providers' Counseling Skills
The goal if this intervention study is to test the feasibility of an intensive internvention to train physicians in adherence counselling methods.
1R01 MH 092238-01 Wilson (PI) 9/30/10-8/31/13
Improving the Self-Report of Medication Adherence Problems in HIV
The goal this project is to develop a small set of well-tested items that can be used by clinicians and researchers to diagnose medication adherence problems in persons with HIV.
1RC4 AG 039072-01 Wilson (PI) 9/15/10-8/31/13
Nudging Doctors to Collaborate with Pharmacists to Improve Medication Adherence
The overall goal of this study is to conduct a pilot test of an intervention that delivers timely diagnostic information about nonadherence to physicians, and then compares the effectiveness of two ways to provide pharmacist services to primary care physicians and their patients. Role: PI
T32HS019657 Mor (PI)7/1/10-6/30/13
NRSA Postdoctoral Comparative Effectiveness Development Training Award
This proposed supplement in CER takes advantage of our successful long-standing post-doctoral training program, wide array of relevant available courses and seminars, and a vibrant and expanding research environment that has experienced substantial growth in new faculty doing health services research and externally-funded research.
R21 MH092781-01 Laws (PI) 8/9/11 -7/31/13
Explanatory models of illness and decision heuristics in HIV care
This proposed research will elucidate and categorize patients explanatory models of illness in HIV care,
Their degree of concordance with biomedical understanding, and relationship to self-care behavior
Including anti-retroviral adherence