The VOICE of UPMC Shadyside Winter 2021–2022

Support for “Unprecedented” Research

The health services research of Bruce L. Jacobs, MD, MPH aims to improve the access, delivery, and quality of urologic cancer care

Although the Shadyside Hospital Foundation cannot compete with the National Institutes of Health in the size of its research grants, the Foundation often fills a unique niche in helping valuable medical research take off and grow. One example is the health services research of Bruce L. Jacobs, MD, MPH, a UPMC Shadyside urologist and assistant professor of urology at the University of Pittsburgh School of Medicine.

“Bruce has created what I would argue is one of the top four or five health services research programs in the country,” says Joel Nelson, MD, Frederic N. Schwentker Professor and chairman of the Department of Urology at Pitt. “The Foundation’s support has helped him develop a program that is, frankly, unprecedented.”

What is health services research?

According to the Institute of Medicine, this multidisciplinary field examines many aspects of health care services, such as access to care as well as its use, costs, quality, delivery, organization, financing, and outcomes. Creating new knowledge to improve care, health services research depends not only on health professionals but also on statisticians, health economists, behavioral scientists, and more.

Dr. Jacobs’ research focuses in particular on ways to improve the access, delivery, and quality of urologic cancer care, especially through studies that use behavioral interventions to change care for the better. In addition, his goal is to introduce medical students, residents, and fellows to an innovative research area that can have enormous benefit for patients.

A range of projects that improve care

The Shadyside Hospital Foundation has helped Dr. Jacobs, the son of longtime Shadyside oncologist Samuel A. Jacobs, MD, advance several projects. One study involved combating the opioid epidemic by trying to steer surgeons toward decreased opioid prescribing while still ensuring their patients’ comfort following prostate or kidney removal.

“Multiple studies have shown that if you take a surgical patient who has no history of opioid use, and you give them opioids after their surgery, 6 percent of them will become addicted,” Dr. Jacobs says. “That is staggering.

"Bruce has created what I would argue is one of the top four or five health services research programs in the country.”
- Joel Nelson, MD Frederic N. Schwentker Professor and Chairman of the Department of Urology, University of Pittsburgh

“Our goal is trying to reduce the use of opioids so that we can reduce the addiction to them — but do it in a way where we have alternatives so that people aren’t in pain. Our study of nearly 700 patients over one and a half years showed that those discharged with and without opioids did not differ in their perception of postoperative pain management, activity levels, psychiatric symptoms, or somatic symptoms,” explains Dr. Jacobs. “Patients who went home with just Tylenol and Motrin versus opioids did not complain of more pain. And, when we made surgeons aware of our goals and findings, the use of opioids for these prostatectomy patients dramatically decreased.”

This study was reported in the prestigious journal Cancer on January 15, 2021, in an article titled “Large reduction in opioid prescribing by a multipronged behavioral intervention after major urologic surgery.” The Shadyside Hospital Foundation is also supporting Dr. Jacobs in further research and behavior-changing interventions, such as improving the use of antibiotics within the urology department and reducing admissions for bladder cancer patients.

“I’m very grateful to the Foundation, especially during a time when the NIH is only able to fund 10 out of a hundred requests,” Dr. Jacobs comments.

“Bruce’s work is something I think the Shadyside community should be really very proud of,” states Dr. Nelson.