We propose a patient safety CERT focused on the theme of Tools for Optimizing Medication Safety (TOPMEDS). The long term goal is to improve patient safety by developing and refining tools for safer medication use. The short term objective is to develop, test, deploy and disseminate tools and training materials in four key areas: statistical methods for large-scale studies of comparative drug safety and effectiveness, opioid prescribing and dosing for acute pain, methods for preventing and detecting drug name confusion errors, and patient-centered, language concordant drug information. We will carry out studies with the following specific aims: 1. Develop and apply a multivariate, person-time logistic regression model for large-scale adverse drug event screening. 2. Improve the safety and effectiveness of inpatient acute pain care by developing and validating a novel, web-based simulator to train prescribers in the proper selection and dosing of opioids. 3. Refine a standard battery of tests for pre-market safety screening of drug names, and develop and test methods for preventing and detecting drug name confusion errors using electronic medical records. 4. Rigorously evaluate a low literacy strategy for promoting safe and effective prescription medication use among English and Spanish-speaking patients in an urban primary care setting. Together the projects address all five of the programmatic interest areas: comparative effectiveness, patient safety, development of tools, health care system interventions, and translation into policy or practice. UIC will host the center, with collaborators at Rush Universit Medical Center, Northwestern University, University of Chicago, the Brigham and Women's Hospital, Discerning Systems, Inc., the Institute for Safe Medication Practices, and the National Patient Safety Foundation. Our investigators are national and international leaders in statistics (Robert Gibbons), health literacy (Michael Wolf), drug name confusion (Bruce Lambert), health information technology (Gordon Schiff, Bill Galanter), pain care (Robert McNutt and Diana Wilkie) medication error prevention (Michael Cohen) and patient safety (Tim McDonald, Diane Pinakiewicz). PUBLIC HEALTH RELEVANCE: Patients are not as safe as they should be. Medication errors and inappropriate use of medicines, by health professionals and patients, cause a great deal of harm. The proposed research will make patients safer by developing and sharing tools for safer medication use, including tools for detecting drug risks, for training young doctors, for preventin medication errors and for making drug information easier to understand.