Volume 2, Issue 2

• From Chair Betsy Sleath
• New Faces and New Places
• Alumni Spotlight
• Faculty Spotlight
• Recent Grants, Publications, and Presentations

From Chair Betsy Sleath

Hi! Faculty in the Division of Pharmaceutical Outcomes and Policy have been very busy since our last digest came out.

DPOP Retreat

On June 3-4, the division traveled to Asheville, North Carolina, for our annual retreat to create strong collaborations with health-care providers and researchers in western North Carolina.

We kicked off the event with a meet-and-greet on June 3 with members from UNC-Asheville, Community Care of Western North Carolina, Mountain Area Health Education Center, Mission Hospital, and other health-care providers from the area. On June 4, a larger group—including more representatives from MAHEC, CCWNC, Mission Hospital, and the North Carolina Translational and Clinical Sciences Institute—gave an overview of their respective organizations. We then discussed possible projects that could be developed in the Asheville area and how to turn our ideas into projects and grant submissions. The projects we discussed covered three areas: healthy aging and chronic disease management, research focusing on the underserved, and models of care.

Symposium on Communicating Medication Risks and Benefits to Patients

On September 6, division vice chair Sue Blalock, PhD, and I participated in a symposium titled “Improving the Communication of Medication Harms and Benefits to Patients — Research-Based Developments from the UK and USA” at the International Conference on Communication in Healthcare in St. Andrews, Scotland. The symposium, chaired by Blalock, highlighted the importance of communicating information about medication risks and benefits to patients in a way that is meaningful and provides patients with the information and tools they need to make well-informed medication self-management decisions.

Four speakers presented as part of the symposium:

• Betty Chewning from the University of Wisconsin spoke about a randomized controlled trial that evaluated an intervention to increase adolescents’ understanding of the benefits and side effects associated with oral contraceptives.
• Theo Raynor from the University of Leeds in the United Kingdom, spoke about European legislation concerning the written prescription drug information that is distributed to patients in the European Union and the extent to which currently available materials meet patient needs.
• I spoke about the creation of the U.S. Food and Drug Administration’s Risk Communication Advisory Committee, which was established in 2008 to improve communication to the public about the risks and benefits of products that the FDA regulates.
• Lastly, Blalock wrapped up the symposium by highlighting key points raised by the other speakers and discussing common and unique challenges confronted in different countries.

Due to the excellent feedback that the conference received from participants, we have been invited to submit a full paper for a Special Issue of Patient Education and Counseling, which will be dedicated to the work that was presented during the conference.

Also in this issue of the digest, we welcome several new faces, introduce you to associate professor Joel Farley, and catch up with some of our recent alumni. Enjoy!

Betsy Sleath, PhD
George H. Cocolas Distinguished Professor and Chair
Division of Pharmaceutical Outcomes and Policy

New Faces and New Places

The division welcomes Mrudula Borse and Robert Overman to our graduate program. Borse comes to us from this University of Toledo, where she studied administrative pharmacy. Overman is a graduate of Cleveland State University with a background in public health.

We would also like to welcome Stacy Bailey, PhD, MPH, who joined DPOP as an assistant professor at the beginning of October. She comes to us from the Division of General Internal Medicine and Geriatrics at the Northwestern University Feinberg School of Medicine.

DPOP alum Chris Gillette, PhD, is an assistant professor of pharmacy administration at Marshall University in Huntington, West Virginia. Gillette graduated in May, and his dissertation was titled “The Effect of Risk and Side Effect Communication on Asthma Medication Adherence.”

Alum David Wei, PhD, is a pharmacy informaticist at Community Care of North Carolina. He graduated from the School in 2012, and his dissertation was titled "Economic Evaluation of Biological Therapy Use Among Patients with Crohn’s Disease."

Alvin Wu, PhD, MHPA, BPharm, who has been the Humana/CHA/DPOP Research Fellow in DPOP for the past two years, has accepted a tenure-track assistant professor position in the School of Pharmacy at Taipei Medical University. He is conducting research in the area of mental health with other faculty from the university as well as researchers from the United States while teaching two courses—pharmacy administration and pharmacoepidemiology.

Alumni Spotlight: Emma Wang, PhD, MHPA

As an international student in the Division of Pharmaceutical Outcomes and Policy, Chi-Chuan (Emma) Wang , PhD, MHPA, found the multidisciplinary training environment at the UNC Eshelman School of Pharmacy to be a solid foundation on which to enhance her independent research skills. A year after earning her PhD from the School, she is putting those skills to good use in her efforts to improve health in Taiwan, her home country.

Wang is currently a full-time postdoctoral fellow at National Taiwan University and a part-time research health economist with Research Triangle Institute Health Solutions. She is working on a project evaluating the long-term effect of bisphosphonates among patients with osteoporosis. She is also pursuing her research interests in the evaluation of medicine utilization patterns and effectiveness of medication treatments among patients with mental illnesses.

Her goal, Wang says, is to improve population health by educating locals on clinical decision-making processes and influencing health policies.

Wang, who obtained her BS in pharmacy at National Taiwan University and her master of health policy and administration at Washington State University, credits her experience in DPOP with preparing her for the challenges she faces in her busy daily life. She spends a significant amount of time searching literature and writing proposals. She also provides mentoring services to undergraduate students interested in the field of social administrative pharmacy and wants to design a course in pharmacoeconomics and pharmacoepidemiology for pharmacy and graduate students.

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Faculty Spotlight: Joel Farley, PhD

Our faculty spotlight this issue falls on Joel Farley, PhD. He joined the School in 2006 and was recently promoted to associate professor in DPOP, where he is also the director of graduate studies.

Farley specializes in the assessment of pharmaceutical policy changes on clinical, economic, and epidemiologic outcomes in vulnerable patient populations. His expertise lies in analyzing claims data from secondary sources, including publicly available surveys such as the Medical Expenditure Panel Survey and the Medicare Current Beneficiary Survey and private health insurance claims data from managed care groups, including United Health Care and Blue Cross Blue Shield of North Carolina.

Currently, Farley’s research program includes

• funded projects to examine continuity of medication prescribing and its effect on health outcomes (AHRQ – 1 R21 HS19445-01);
• an evaluation of UNC Hospital’s Pharmacy Assistance Program, which is designed to improve access to medications for patients who are not otherwise able to afford them (NC TraCS Institute Grant — 550KR21209); and
• an examination of the effect of Community Care of North Carolina’s medical home model on the quality of care for patients with severe mental illness (AHRQ – 1R24 HS019659-01).

Farley’s prior research has examined the effect of Medicaid prescription-managed-care policies on economic and clinical outcomes in patients with mental illness. He currently has a contract with North Carolina Community Care Networks to examine the effect of a provider registry implemented in the North Carolina Medicaid program on improving antipsychotic prescribing in pediatric patients. He has also served as a consultant to Blue Cross Blue Shield of North Carolina to support the evaluation of a copayment waiver for medications used to treat chronic diseases.

Recent Grant, Publications, and Presentations

New Funding

Participation in Cancer Genomic Research: Perspectives and Experiences of Cancer Patients
Lynn Dressler (PI), UNC Odum Institute for Social Science Research/UNC School of Arts and Sciences
7/2012-7/2-13 - $14, 897

Methods to Increase Validity of Comparative Effectiveness Research in the Elderly

Gang Fang (CI), Patient-Centered Outcomes Research Institute

7/2012-6/2014 - $673,395

Assessing Racial/Ethnic Differences in Barriers to Hepatitis C Therapy in a Cohort of HIV/HCV-Coinfected Patients
Christine Oramasionwu (PI), UNC CFAR Developmental Core
7/2012-6/2013 - $6,285

Patient adoption of an Internet based diabetes medication tool to improve adherence
Betsy Sleath (PI), Delesha Carpenter (CO-PI), Stefanie Ferreri (CO-I), Skip Cummings (CO-I), Susan Blalock (CO-I), Charles Lee (CO-I), Darren DeWalt (CO-I), UNC Center for Diabetes Translational Research to Reduce Health Disparities
9/2012-8/2013 - $39,819

Developing and Evaluating Methods for Record Linkage and Reducing Bias in Patient Registries
Gang Fang (Project PI), Alan Brookhart and Til Sturmer (Program Director), AHRQ DEcIDE-2 Contract
9/2012-7/2014 - $1,112,042

Recent Publications

Blalock SJ, Keller S, Nau D, Frentzel EM.  Development of the Consumer Assessment of Pharmacy Services survey.   J Am Pharm Assoc, 2012;52(3):324-32.  PMID: 22618972

Sleath BL, Blalock SJ, Stone JG, Skinner AC, Covert D, Muir K, Robin AL. Validation of a Short Version of the Glaucoma Medication Self-Efficacy Questionnaire.  Br J Ophthalmol, 2012;92(2):258-62.  PMID: 21610264

Cox WC, Smith H, Blalock SJ.  Predictors of academic difficulty in a Doctor of Pharmacy program.  Int J Pharm Education, 2012;8(1).  Available at:  http://www4.samford.edu/schools/pharmacy/ijpe/sp012/sp12.html

Carpenter D.M., Fisher E.B., & Greene S.B. (2012) Shortcomings in public and private insurance coverage of diabetes self-management education and support. Population Health Management, 15(3): 144-148.

Kadis J.A., Carpenter D.M., & DeVellis R.F. (2012) Does medication adherence-related support from physicians and partners predict medication adherence for vasculitis patients? Journal of Behavioral Medicine, 35: 115-123.

Elstad E.A., Carpenter D.M., DeVellis R.F., and Blalock S. (2012) Patient decision making in the face of conflicting medication information. International Journal of Qualitative Studies of Health and Well-being, 7: Available online at: http://dx.doi.org/10.3402/qhw.v7i0.18523.

Dressler, Lynn G. (2012). Return of research results from pharmacogenomics versus disease susceptibility studies: what’s drugs got to do with it? Pharmacogenomics 13(8), 935-949.

Wu CH, Farley JF, Gaynes BN (2012). “The association between antidepressant dosage titration and medication adherence among patients with depression”. Depression and Anxiety.

Farley JF, Hansen RA, Yu-Isenberg KS, Maciejewski ML. (2012) “Antipsychotic adherence and its correlation to health outcomes for chronic comorbid conditions” The Primary Care Companion for CNS Disorders. Published online at http://article.psychiatrist.com/?ContentType=START&ID=10007931.

Farley JF, Wansink D, Lindquist JH, Parker JC, Maciejewski ML. (2012) “Medication Adherence Changes following Value Based Insurance Design (VBID)” American Journal of Managed Care. 18(5):41-50.

Gaynes B, Dusetzina SB, Ellis A, Hansen RA, Farley JF, Sturmer T. (2012) “Treating depression after initial treatment failure:  Directly comparing switch and augmenting strategies in STAR*D.” Journal of Clinical Psychopharmacology. 32(1):114-119

Katz AJ, Dusetzina SB, Farley JF, Ellis AR, Gaynes BN, Castillo WC, Sturmer T, Hansen RA. (2012) “Adverse events following antidepressant switch in STAR*D: The influence of patient experiences during initial treatment with citalopram.” Pharmacotherapy. 32(3):234-243.

Oramasionwu CU, Hunter JM, Brown CM, Morse GD, Lawson KA, Koeller JM, Frei CR.Cardiovascular disease in Blacks with HIV/AIDS. Open AIDS J 2012;6:29-35.

Sleath B, Carpenter D, Slota C, Williams D, Tudor G, Yeatts K, Davis S, Ayala G.  Communication during pediatric asthma visits and self-reported adherence. Pediatrics. 2012 Sept 3 [Epub ahead of print]. PMID: 22974226

Recent Presentations

Blalock SJ, Chewning B, Raynor DKT, Sleath BL.  Improving communication of medication harms and benefits to patients: Research-based developments from the UK and USA.  Symposium to be presented at the International Conference on Communication in Healthcare, St. Andrews, Scotland, September 2012.

Benyam Muluneh, Maurice Alexander, Allison Mary Deal, Janell Marker, Jennifer Neal, Stephen A Bernard, John Valgus, Lynn G. Dressler. Prospective evaluation of perceived barriers to medication adherence by patients on oral antineoplastics. American Society of Clinical Oncology. June, 2012. Chicago, Illinois.

Lynn G. Dressler , Janell Markey, Allison Deal and Bartha Knoppers  on behalf of the Ethics and Policy Working Group of the International Cancer Genome Consortium (ICGC). Return of individual results from cancer genomic research: ICGC researcher experiences and institutional practices. 6^th Annual Meeting of the International Cancer Genome Consortium (ICGC), Cannes, France, March, 2012.

Mayer CL, Lauffenburger JC, Farley JF, Brouwer K, Fried M, Hawke RL. “Medication use in patients with chronic Hepatitis C (HCV) from a U.S. commercial claims database: Inadequacy of prescribing information for assessment of potential drug interactions.” American Association for the Study of Liver Diseases (AASLD) 63rd Annual Meeting, Boston, MA, November 9-13, 2012.

Sikich L, Christian R, Sheitman B, Barnhill J, Chrisman A, Palmes G, Wegner L, McKee J, Farley JF, Wei D, Trygstad T, Wegner S. “A public health approach for increasing physician awareness of antipsychotic risks in  youth” American Academy of Child and Adolescent Psychiatry 59th Annual Meeting, San Francisco, CA, October 23-28, 2012.

Christian RB, Farley JF, Wei D, Trygstad T, Sheitman B, Pfeiffenberger T, Sikich LM. (2012) “Antipsychotics- Keeping it Documented for Safety (A+KIDS): Initial experience and findings from a state medication Registry.” International Society for Pharmacoepidemiology (ISPE) 28th International Conference on Pharmacoepidemiology and Therapeutic Risk Management, Barcelona, Spain, August 22-26, 2012.

Ellis A, Dusetzina SB, Hansen RA, Gaynes B, Farley JF, Sturmer T. “Comparison of Propensity-Score-Weighted and -Matched Estimates in a Comparative Effectiveness Study: A Demonstration Using STAR*D Trial Data”. International Society for Pharmacoepidemiology (ISPE) 28th International Conference on Pharmacoepidemiology and Therapeutic Risk Management, Barcelona, Spain, August 22-26, 2012.

Maciejewski ML, Powers BJ, Sanders L, Farley JF, Hansen RA, Sleath B, Voils CI. “Implications of the continuity of medication management for the medical home of complex patients” Academy Health 2012 Annual Research Meeting, Orlando, FL, June 24-26, 2012.

Betsy Sleath, PhD, Susan Blalock, PhD, Scott Lawrence, MD, Delesha M. Carpenter, PhD, MSPH, Brenda DeVellis, PhD, Robyn Sayner, PharmD.  “The extent to which providers involve glaucoma patients in medication treatment decisions during medical visits” Poster presented at the International Conference on Communication in Healthcare, St. Andrews, Scotland, September 2012.

Sleath B. Communication during pediatric asthma visits and self-reported adherence one month later. Presented at the International Conference on Communication in Healthcare, St. Andrew’s Scotland, September 2012.

Lauffenburger J, Balasubramanian A, Farley J, Critchlow C, O’Malley C, McClurg M, Pate V, Brookhart M.  “Are low-cost generic prescriptions faithfully captured in US pharmacy claims databases?”.  Abstract presented at the International Conference on Pharmacoepidemiology & Therapeutic Risk Management Conference, Barcelona, Spain, August 2012.

Rishi J. Desai, Jaya K. Rao, Andrea K. Biddle. Cost-effectiveness of golimumab for the treatment of rheumatoid arthritis.  Poster presentation, ISPOR 17^th Annual International Meeting, Washington, DC June 2012.