JOHN EDWARD ZEBER
Center for Applied Health Research
2102 Birdcreek Drive (254) 215-9877
Temple, TX 76502 zeber@uthscsa.edu
Education:
·
University of
Michigan Doctor of Philosophy (2004): Health
Services Organization & Policy (HSOP) – Sociology cognate
·
University of
Washington Masters
of Health Administration (1998)
Teaching
Assistant: Statistics,
Quantitative Methods
Research
Assistant:
“Managed Care and Risk-Bearing Contracts”
·
Occidental College Bachelor of Arts,
Economics (1987)
Post-graduate Training:
·
University of Texas Health Science Center, San Antonio – Multi-disciplinary Clinical Research Scholars Training Program
(K12) awardee (Fall 2006-Fall 2008).
·
Veterans Affairs Health Services Research & Development (HSRD),
Summary of Research Interests, Experience, and
Professional Goals:
Over the past decade conducting health services research, my primary objectives have focused on three issues: 1) health outcomes for patients with serious mental illness (schizophrenia, bipolar disorder, PTSD, depression); 2) barriers to medication and treatment adherence, along with the potential clinical and financial ramifications; 3) ethnicity, culture, and reducing disparities. I have gained a national reputation in these areas, including invited talks and conference presentations, plus several highly cited publications. I have served on two expert panels on medication adherence, one an ongoing international work group, with my studies on pharmacy copayments highlighting a VA report concerning policy effects. A Washington Post lead article featured my work on ethnic disparities in psychiatric diagnosis, followed by an invitation to speak at a Congressional Black Caucus event. Most recently, I accepted an offer to serve as guest journal editor for a special ethnicity issue of Depression Research & Treatment. From collaborative work across the VA and academic partnerships, I have also accumulated experience on projects pertaining to cost-effectiveness analysis, post-deployment experiences of veterans seeking VA care, and enhanced implementation of the chronic care model or patient-centered medical home principles. As I continue developing my research portfolio, I look forward to making contributions to my institutions and the wider research community, working in a leadership role within our newly established health outcome center to set a clincially significant research agenda, while also mentoring junior investigators.
Professional Experience:
Academic
Appointments
Texas A&M Health
Science Center (TAMHSC),
Department of Medicine: Associate Professor (approved,
April 2011). Occasional
lectures, course development, faculty collaboration, and research mentoring of
students, residents, and fellows.
Texas A&M School
of Rural Public Health,
Department of Behavioral Science: Joint Associate
Professor (pending,
January 2011). Roles and responsibilities to be determined.
University of Texas
Health Science Center at San Antonio (UTHSCSA), Department of Psychiatry: Adjunct
Faculty (Assistant
Professor September 2006 – 2010). Active involvement in funded
projects, occasional lectures, interdisciplinary research, and career
development activities.
University of Texas
School of Public Health, Division of Management, Policy and
Community Health: Adjunct Faculty (April 2005 – present). Similar to above roles; also co-developed a course in Health
Management and Policy, for MHA program (Spring-Summer 2007)
Health
Services Research
Scott & White Healthcare: Center
for Applied Health Research (CAHR) and Central Texas Veterans Health
Care System – Temple, TX (September 2010 to present): Co-Director, CAHR Health
Services Outcomes Core / VA Investigator. Recruited to help start a new
applied health research and outcomes center at Scott & White, as a joint
effort with the Central Texas VA. Cross-divisional center devoted to
translational and outcomes research for patients for chronic medical and
psychiatric conditions, mentoring and professional development, and
collaboration across HMO Research Network members.
Veterans Evidence-Based Research,
Dissemination, and Implementation Center (VERDICT): South Texas Veterans Health
Care System HSRD – San Antonio, TX (2006-August 2010):
Investigator. A two-year post-doctoral appointment transitioned into
full position as VA investigator, with both practical research experience and
ongoing didactic education. Projects included dissertation follow-up efforts,
other manuscripts, collaboration with VA and university investigators,
conference presentations, and development of research grants. Ongoing
collaboration on several projects, following transition to positions in
Temple.
Veterans
Administration Ann Arbor Healthcare System, Health Services Research &
Development (HSRD) – Ann Arbor, MI (1999-2004): Research
Associate with the Serious Mental Illness Treatment Research and
Evaluation Center (SMITREC). Diverse responsibilities include grant
preparation, database management, literature reviews, authorship on papers,
conference presentations, involvement with special projects (e.g., national
registry of veterans with schizophrenia, medication adherence), survey coding,
and data analysis. Increasing emphasis in the specialty area of depression and
schizophrenia research topics.
Provider
Relations
Group
Health Cooperative –
Inland Behavioral Medical Group – Upland, CA (1995):
Provider Relations Manager. Responsible for developing a psychiatric
provider network with a growing Independent Physicians Association (PA).
Involved with marketing, credentialing and database management.
Office
Management & Administrative
PLP & Associates – Pasadena, CA
(1991-1995): Business Manager. Sole responsibility for managing
psychological group and outpatient eating disorders clinic. Budgeting, payroll,
policy development, tax preparation, financial analysis, marketing, patient
intake, and managed care coordination for $500,000 practice. Discretion given
to initiate projects and explore business options.
Wanda
B. Olsen, M.D. – Pasadena, CA (1989-1990): Office Manager. Daily
management of private psychiatry office, billing/ receivables, scheduling,
hospital coordination, patient referrals, other responsibilities.
Hospital & Nursing
Las
Encinas Hospital – Pasadena, CA (1987-1989): Served in
different nursing roles, including private duty and floor capacities.
Later appointed as Admissions Supervisor / Acting Director, in addition to
evening supervision.
Beverly
Enterprises – Riverside, CA (1984-1987): Numerous
departments at long-term psychiatric hospital during college vacations,
including nursing (certified nurses assistant), floor supervision, medical
records, activities, program coordination, and front office.
RESEARCH EXPERIENCE
Publications:
57) Mackey K, Parchman MP, Leykum LK, Lanham HJ,
Noel PH, Zeber JE. “Impact of the Chronic Care Model on medication
adherence when patients perceive cost as a barrier”. Prim Care Diabetes. 2012 Jan 18. [Epub ahead of print]
56) Tsan J, Zeber JE, Stock EM, Copeland
LA. “Primary care mental health integration and persistence in care among Iraq
and Afghanistan war veterans”. Psychological
Services. [In press]
55) Arar N, Noel PH, Leykum LK, Zeber JE,
Romero R, Parchman ML. “Implementing quality improvement in small, autonomous
primary care practices: implications for the patient centered medical home.” Quality in Primary Care. 2011;
19(5):289-300.
54) Maples NJ, Copeland LA, Zeber JE, Li
X, Boone C, Moore TA, Dassori D, Velligan DI, Miller AL. “Medication management
coordinators to improve continuity of care after psychiatric hospitalization”. Psychiatric Services. [In press]
53) Zeber JE, Gonzalez JM, VanDorn RA,
Interian A. “The challenge of incorporating cultural issues into depression
treatment: translating diverse current research approaches into clinical
practice”. Depression Research &
Treatment. [In press]
52) Copeland LA, Zeber JE. “Ethnicity and
race variations in receipt of vascular surgery among depressed veterans”. Depression Research & Treatment. [In
press]
51) Noel PH, Zeber JE, Pugh MJ, Finley EP,
Parchman ML. “A pilot survey of post-deployment health care needs in small
community-based primary care clinics”. BMC
Family Medicine; 2011 Jul 29; 12:79].
50) Copeland LA, Ettinger AB, Zeber JE,
Gonzalez JM, Pugh MJ (2011). “Psychiatric and medical admissions observed among
elderly patients with new-onset epilepsy”. BMC
Health Services Research, 11:84.
49) Copeland LA, Zeber JE,
Bingham MO, Pugh MJ, Noël PH, Schmacker ER, Lawrence VA. (2011). “Transition from
military to VHA care: Psychiatric health services for Iraq/Afghanistan
combat-wounded”. Journal of Affective Disorders,
130(1-2):226-30.
48) Zeber JE, Miller AL, Copeland LA,
McCarthy JF, Zivin K, Valenstein M, Greenwald D, Kilbourne AM. (2011) “Medication
adherence, ethnicity, and the influence of multiple psychosocial and financial
barriers.” Administration
& Policy in Mental Health / Mental Health Services Research,
38(2):86-95.
47) Dassori AM,
Copeland LA, Zeber JE, Miller AL. (2011). “Factors
in second-generation antipsychotic switching patterns in a national sample of
older veterans with schizophrenia”. Psychiatric
Services, 62(1):47-53.
46)
Gonzalez JM, Alegria M, Prihoda TJ,
Copeland LA, Zeber JE. (2011). ”How the
relationship of attitudes toward mental health treatment and service use
differs by age, gender, ethnicity/race and education”. Social Psychiatry & Psychiatric Epidemiology, 46(1):45-57.
45) Finley EP, Zeber JE,
Pugh MJ, Cantu G, Copeland LA, Parchman ML, Noel PH. (2010). “Postdeployment
healthcare for returning OEF/OIF military personnel and their social networks:
a qualitative approach”. Military
Medicine, 175(12):953-7.
44) Zeber JE, Noel PH, Pugh MJ, Copeland
LA, Parchman ML. (2010). “Family perceptions of post-deployment healthcare
needs of Iraq/Afghanistan military personnel”. Mental Health in Family Medicine, 7(3):135-43.
43) Zeber JE, Copeland LA, Pugh MJ.
(2010). “Variation in antiepileptic drug adherence among older patients with
new-onset epilepsy”. Annals of
Pharmacotherapy, 44(12):1896-904.
42) McCarthy JF, Valenstein M, Zivin K, Zeber
JE, Kilbourne AM. (2010). ” Access-related
measures and out-of-system utilization among veterans with bipolar disorder”. Psychiatric Services, 61(10):1035-8.
41) Copeland
LA, Parchman ML, Zeber JE, Lawrence VA, Downs JR, Miller AL.
(2010). “Prediabetes
assessment and follow-up in older veterans with schizophrenia”. American Journal of Geriatric Psychiatry,
18(10):887-96.
40) Parchman ML, Zeber JE, Palmer RF.
(2010). ”Participatory decision making, patient activation, medication
adherence and intermediate clinical outcomes in type 2 diabetes: a STARNet
study”. Annals of Family Medicine,
8(5):410-7.
39) Zeber JE, Parchman ML. (2010). “Cardiovascular
disease in type 2 diabetes: attributable risk due to modifiable risk factors”. Canadian
Family Physician,
56(8):e302-7.
38) Van Cott AC, Cramer JA, Copeland LA, Zeber
JE, Steinman MA, Dersh JJ, Glickman ME, Mortensen EM, Amuan ME, Pugh MJ.
(2010). “Suicide-related behaviors in older patients with new anti-epileptic
drug use: data from the VA Hospital System”. BMC Medicine, 8:4.
37) Ettinger AB, Copeland LA, Zeber JE,
Van Cott AC, Pugh MJ. (2010). “Are psychiatric disorders independent risk
factors for new-onset epilepsy in older individuals?” Epilepsy & Behavior, 17(1):70-4.
36) Evans-Lacko
SE, Zeber JE, Gonzalez JM, Olvera RL. (2009). “Medical comorbidity
among youth diagnosed with bipolar disorder in the United States.“ Journal of Clinical Psychiatry,
70(10):1461-66.
35) Medication
Adherence Expert Panel (Velligan DI, chair). (2009) “The
expert consensus guideline series: adherence problems in patients with serious
and persistent mental illness.” Journal
of Clinical Psychiatry, 70(suppl 4):1-46.
34) Perron BE, Zeber JE, Kilbourne AM,
Bauer MS. (2009). “A brief measure of perceived clinician support by patients
with bipolar spectrum disorders”. Journal
of Nervous and Mental Disorders, 197(8):574-9.
33) Copeland LA, Zeber JE, Wang CP,
Lawrence VA, Parchman ML, Lawrence VA, Valenstein M, Miller AL. (2009).
“Patterns of primary care and mortality among patients with schizophrenia or
diabetes: a cluster analysis approach to the retrospective study of healthcare
utilization”. BMC Health Services
Research, 9:127-37.
32) Hope OA, Zeber JE,
Kressin NR, Bokhour BG, VanCott AC, Cramer JA, Amuan ME, Knoefel JE, Pugh MJ.
(2009). “New-onset geriatric epilepsy care: race, setting of diagnosis, and
choice of antiepileptic drug”. Epilepsia,
50(5):1085-93.
31) Ilgen MA,
Czyz EK, Welsh DE, Zeber JE, Bauer MS, Kilbourne AM. (2009). “A collaborative therapeutic
relationship and risk of suicidal ideation in patients with bipolar disorder”. Journal of Affective Disorders,
115(1-2):246-51.
30) Copeland LA, Miller AL, Welsh DE, McCarthy
JF, Zeber JE, Kilbourne AM. (2009). “Clinical and
demographic factors associated with homelessness and incarceration among VA
patients with bipolar disorder”. American
Journal of Public Health, 99(5):871-77.
29) Zeber JE,
Copeland LA, McCarthy JF, Bauer MS, Kilbourne AM. (2009). “Perceived
access to general medical and psychiatric care among veterans with bipolar
disorder”. American Journal of
Public Health, 99(4):720-7.
28) Zeber JE, Pearson D, Smith D. (2009).
“Analysis of health appointment no-shows”. Primary
Health Care, 19(2):25-9.
27) Copeland LA, Lawrence VA, Zeber
JE. (2009). “Depression and the long-term effects on postoperative
outcomes [letter]”. Annals of
Surgery, 249(2):353-4.
26) Zeber JE, Copeland LA,
Hosek BJ, Karnad AB, Lawrence VA, Sanchez-Reilly SE. (2008). “Cancer rates, medical
comorbidities, and treatment modalities in the oldest patients”. Critical Reviews in Oncology /Hematology,
67(3):237-42.
25) Pugh MJ, Zeber JE, Copeland LA,
Tabares JV, Cramer JA. (2008).
“Psychiatric disease burden profiles among veterans with epilepsy: the
association with health services utilization”. Psychiatric Services, 59(8):925-8.
24) Copeland LA, Zeber JE,
Pugh MJ, Mortensen EM, Restrepo MI, Lawrence VA. (2008). “Postoperative complications in the seriously
mentally ill: a systematic review of the literature". Annals of Surgery, 281(1):31-8.
23) Velligan DI, Diamond PM, Mintz J, Maples N,
Li X, Zeber JE, Ereshefsky L, Lam YW, Castillo D, Miller AL. (2008).
“The use of individually tailored environmental supports to improve medication
adherence and outcomes in schizophrenia”. Schizophrenia
Bulletin, 34(3):483-93.
22) Zeber JE, Copeland LA, Good CB, Fine MJ,
Bauer MS, Kilbourne AM. (2008). “Therapeutic alliance perceptions and
medication adherence in patients with bipolar disorder”. Journal of Affective Disorders, 107(1-3):53-62.
21) Copeland LA, Zeber JE, Salloum IM,
Pincus HA, Fine MJ, Kilbourne AM. (2008). “Treatment adherence and
illness insight in veterans with bipolar disorder”. Journal of Nervous and Mental Disorders,
196(1):16-21.
20) Noël PH, Parchman ML, Williams JW Jr, Cornell
JE, Shuko L, Zeber JE, Kazis LE, Lee AF, Pugh JA. (2007). “The challenges
of multimorbidity from the patient perspective” Journal of General Internal Medicine, 22(supp3):419-24.
19) Parchman ML, Zeber JE,
Romero RR, Pugh JA. (2007).
“Risk
of coronary artery disease in type 2 diabetes and the delivery of care
consistent with the chronic care model in primary care settings: A STARNet
Study”. Medical Care,
45(12):1129-34.
17) Cornell JE, Pugh JA, Williams
JW, Kazis L, Lee AF, Parchman ML, Zeber JE, Pederson T, Montgomery KA,
Noël PH. (2007). “Multimorbidity clusters: clustering binary data from multimorbidity
clusters: clustering binary data from a large administrative medical database”.
Applied Multivariate Research,
12(3):163-82.
16) Zeber JE, Grazier KL, Valenstein M,
Blow FC, Lantz PM. (2007). “Effect of a medication copayment increase in veterans
with schizophrenia”. American Journal of
Managed Care, 13(6, part 2):335-46.
15) Zeber JE, Copeland LA, Amuan M, Cramer
JA, Pugh MJ. (2007). “The role of comorbid psychiatric conditions in health
status in epilepsy”. Epilepsy and
Behavior, 10(4): 539-46.
14) Kilbourne AM, Post EP, Bauer MS, Zeber JE, Copeland LA, Good CB,
Pincus HA. (2007). “Therapeutic drug and cardiovascular disease risk
monitoring in patients with bipolar disorder”. Journal of Affective Disorders, 102(1-3):145-51.
13) Zeber JE, McCarthy JF, Bauer MS,
Kilbourne AM. (2007). “Datapoints: self-reported access to general medical and
psychiatric care among veterans with bipolar disorder”. Psychiatric Services, 58(6):740.
12) Copeland LA, Mortensen EM, Zeber
JE, Pugh MJ, Restrepo MI, Dalack GW. (2007). “Pulmonary disease among
inpatient decedents: Impact of schizophrenia”. Progress in Neuro-Psychopharmacology & Biological Psychiatry,
31(3):720-6
11) Pugh MJ, Hanlon JT, Zeber JE,
Bierman A, Cornell J, Berlowitz DR. (2006).
“Assessing potentially inappropriate prescribing in the elderly Veterans
Affairs population using the HEDIS 2006 quality measure”. Journal of Managed Care Pharmacy, 12(7):537-45.
10) Zeber JE, Copeland LA,
Grazier KL. (2006). “Serious
mental illness, aging, and utilization patterns among veterans”. Military Medicine, 171(7):619-26.
9) Copeland LA, Zeber JE, Rosenheck RA,
Miller AL. (2006). “Unforeseen inpatient
mortality among veterans with schizophrenia”. Medical Care, 44(2):110-6.
8) Pugh MJ, Copeland LA, Zeber JE,
Cramer JA, Amuan ME, Cavosos JE, Kazis LE. (2005). “The impact of epilepsy on health status
among younger and older adults”. Epilepsia, 46(11):1820-7.
7) Blow FC, Zeber JE, McCarthy JF,
Valenstein M, Gillon L, Bingham CR. (2004). “Ethnicity and diagnostic patterns
in veterans with psychoses”. Social Psychiatry & Psychiatric
Epidemiology, 39(10):841-51.
6) Valenstein M, Blow FC, Copeland LA,
McCarthy JF, Zeber JE, Gillon L, Bingham CR, Stavenger T. (2004). “Poor
antipsychotic adherence among patients with schizophrenia: medication and
patient factors”. Schizophrenia Bulletin,
30(2):255-64.
5) Copeland LA, Zeber
JE, Valenstein M, Blow FC. (2003). “Racial disparity in the use of atypical
antipsychotic medications among veterans”.
American Journal of Psychiatry,
160(10):1817-22.
4) Barry KL, Zeber
JE, Blow FC, Valenstein M. (2003). “Effect of strengths model versus
assertive community treatment model on participant outcomes and utilization:
two-year follow-up”. Psychiatric Rehabilitation
Journal, 26(3):268-77.
3) Valenstein M,
Copeland LA, Blow FC, McCarthy JF, Zeber JE, Gillon L, Bingham CR,
Stavenger T. (2002). “Pharmacy data identify poorly adherent patients with
schizophrenia at increased risk for admission”. Medical Care, 40(8):630-9.
2) Valenstein M,
Vijan S, Zeber JE. (2002). “Should we screen for depression in primary
care” [letter]. Annals of Internal Medicine, 136(5):412.
1) Valenstein M,
Vijan S, Zeber JE, Boehm K, Buttar A. (2001). “The cost-utility of
screening for depression in
primary care”.
Annals of Internal Medicine: 134(5):
345-60. [featured article, with editorial]
Manuscripts
under review:
Copeland LA, Wang CP,
Sako E, Mortensen EM, Pugh MJ, Zeber JE, Flynn J, Restrepo MI, MacCarthy
AA, Lawrence VA. “Rates of surgery in the veterans health administration”.
[manuscript under review; Ann Surg]
Zeber JE, Copeland LA, Pugh MJ, Restrepo MI, MacCarthy D,
Lawrence VA. “Surgical
rates of common procedures in veterans with serious mental illness” [manuscript
under review; Am J Psychiatry]
Pugh MJ, Tabares J,
Wang CP, Amuan ME, Van Cott AC, Copeland LA, Zeber JE, Cooper T,
Mortensen EM, Cramer JA, Kanner AM. “Antiepileptic drug monotherapy exposure
and suicide-related behavior in older veterans”. [manuscript under review; American Medical Journal]
Williams EO, Stock EM, Zeber
JE, Copeland LA, Miller NA, Stuart M, Palumbo F. “Payor characteristics
associated with antipsychotic polypharmacy in an ambulatory care setting”.
[manuscript under review, Journal of
Pharmaceutical Health Services Research].
Manuscripts
in preparation:
Williams
EO, Zeber JE et al., “Provider characteristics and antipsychotic
polypharmacy”.
Williams
EO, Zeber JE et al., “Patient facors and the riksk of antipsychotic
polypharmacy”.
Tabares
J, Zeber JE, Pugh MJ et al. “A systematic review of risk factors
associated with AEDs and suicidal behavior”.
Copeland
LA, Zeber JE, Tsan JY, Gonzales J, Stock EM. “Mental Health Care
Preferences of OEF/OIF Veterans in South Texas”.
Zeber JE, Copeland LA, Miller AL, Kilbourne
AM, Velligan D. “Ethnicity and the impact of higher medication copayments among
veterans with schizophrenia”. [manuscript under review; Ethnicity and Health]
Lawrence
VA, Copeland LA, Zeber JE, Pugh MJ, Mortensen EM, Restrepo MI. “Statins
association with reduced postoperative pneumonia”.
Culler
SD, Parchman ML Zeber JE, Robertson M, Romero RA. “Cost of implementing
practice facilitation in primary care clinics to improve diabetes outcomes”.
Zeber JE, Palmer RF, Parchman ML, Copeland LA, Romero RA. “Diabetes
and medication adherence: understanding the association between perceived drug
costs and dimensions of the therapeutic alliance”.
Romero
RL, Zeber JE, Parchman ML. “Implanting organizational strategies to
improve diabetes care delivery using components of the chronic care model:
Preliminary ABC Intervention Study Results”.
Parchman
ML, Zeber JE, Leykum L, Noel PH, Arar N. “Perceptions of the Patient
Centered Medical Home not associated with care delivered through Chronic Care
Model”.
Zeber JE et al. “Cost-related Medication
Adherence and Patients Experience with the Chronic Care Model: Preliminary ABC
Intervention Study Results” [ABCs / NAPCRG poster].
Zeber JE, Copeland LA, Pugh MJ, Mortensen EM,
Zeber JE, Leykum L, Valenstein M, Copeland LA,
Miller AL. “A Cost-Benefit Analysis of Higher Medication Copayments in Veterans
with Schizophrenia”.
Book Chapters:
Epidemiology of co-occurring TBI and PTSD
[invitation to contribute to textbook in progress (Oxford Press) on PTSD,
Traumatic Brain Injury, and Returning OEF/OIF Service Personnel – Copeland LA,
Pugh MJ, Finley EP, Zeber JE].
Risk Bearing and Capital Financing Arrangements in
Integrated Health Systems: Concepts and Cases.
With Douglas Conrad, Ph.D,
Interviews / Press Articles / Newsletters:
Prescriptions for Progress, September 2007 (vol.2,
no.1) and December 2007 issues (vol.2, no.2): Two policy newsletters presenting
my work on copayments, ethnicity, and clinical impact.
CNS Senior Care, June 2006 issue: brief
telephone interview and article on issues pertaining to ethnicity, cultural
competency, potential diagnostic or treatment disparities, and policy issues
among the elderly with mental health disorders (e.g., medication copayments).
Washington Post, June 2005: “Racial Disparities Found in
Pinpointing Mental Illness”
(6/28/05); includes interview with JE Zeber, based upon 2 published
studies pertaining to ethnic differences in diagnosis and treatment – part
for a series on the subject of mental illness and cultural factors.
Medical Post, June 2004: “Atypicals may
aid compliance in schizophrenics”. Vol 40, Issue 22 (http://www.medicalpost.com).
Grants
FUNDED:
Primary Investigator
Post-Deployment Health and Transition
into VA Care [VA Locally Initiated Project #66-014,
John Zeber, PI] – approved and funded for 2009, $50,000. Interview returning
OEF military personnel and community providers regarding treatment needs,
access issues, comfort providing care, and possible transition into the VA
health system.
Effect
of Copayments among Veterans with Bipolar Disorder [Lilly grant,
John Zeber, PI] – approved and funded for 2010, $56,556. Examine the effect of
higher VA medication copayments on prescriptions for mood stabilizers and
atypical antipsychotics, along with health services utilization and costs (ER,
hospital). [currently on hold pending relocation]
Post-Operative
Outcomes and Safety in Schizophrenic Elders [Veterans Affairs VISN 17 grant, John
Zeber, PI] – approved and funded for 2008-2009 ($100,000). Secondary database analysis collecting pilot data on
potential differences in surgery rates and outcomes between patients with
serious mental illness (schizophrenia, bipolar, PTSD) and veterans without
psychiatric conditions. Study will explore issues of competing demands and
treatment delays leading to greater surgical needs and clinical ramifications
(e.g., relapse rates, mortality).
Medication Adherence, Outcomes and
Quality of Life Perceptions [PhRMA Foundation young investigator
research starter grant, John Zeber, PI] – approved and funded for 2007-2008
($60,000). Explore multidimensional aspects of medication adherence in patients
with schizophrenia, plus quality of life and health status outcomes. In a
national cohort study of schizophrenia patients receiving care between
1999-2005 (N=90,000): 1) statistically identify clinically-relevant adherence
sub-groups; 2) compare groups across multiple administrative and SF-36
variables; 3) assess quality of life by mapping SF-36 values to utilities.
Other outcomes include associating adherence / preferences to utilization and
pharmacy costs.
Multi-disciplinary Clinical Training
Program awardee [University of Texas Health Science
Center at
Aging and Serious Mental Illness among
Veterans. Veteran Affairs Locally Initiating Project (LIP - #41-095).
Small grant program for young investigators [John Zeber, PI] – approved and
funded in August 2002, $10,000. Local funding for independent project examining
the association between age, psychiatric diagnosis, and utilization.
FUNDED: Co-Investigator / other
Evaluation of a Pulsed-Xenon
Ultraviolet Room Disinfection Device for Impact on contamination levels of
C.diff and MRSA [Xenex] – Chetan Jinadatha, PI. (5%
effort as Co-I); approved for FY12, $125,000 Examine clinical and
cost-effectiveness of an automated disinfection device.
Surgical Treatment Outcomes for
Patients with Psychiatric Disorders (STOPP) [Veterans Affairs
HSR&D IIR-09-335, Laurel Copeland, PI; 25% effort as co-I. – approved and
funded for FY09-FY10, $381,000. Nothing is known regarding perioperative risk
management and outcomes for veterans with severe mental illness, and by design,
the NSQIP is powerless to address this lack. This retrospective cohort study
uses VA administrative data from FY05 to FY09 to compare surgery rates and
postoperative outcomes (30-day mortality, myocardial infarction and acute
coronary syndrome, deep venous thrombosis or pulmonary embolism, ICU admission,
pneumonia, respiratory failure, sepsis, wound infection, readmission) by
pre-existing SMI status, adjusting for comorbidity and demographic variables.
Retrospective Database Examination of
Longitudinal Outcomes in Burned OEF/OIF Veterans [Veterans
Affairs HSR&D merit supplement] – Val Lawrence, PI. (10% effort as Co-I
through June 2010). Additional aim to examine differential mortality rates
across diagnostic groups with death index data.
Role of Clinical Team Functioning and
Medication Adherence in Diabetes [Veterans Affairs HSR&D merit
supplement IIR-06-063, Mike Parchman, PI] – approved and funded for FY09-FY10,
$141,000 for supplement only (15% as Co-I leading new specific objective). Additional aim to examine clinical microsystem learning
and medication adherence.
Mortality Risk in Veterans with
Schizophrenia and Comorbid Diabetes [Veterans Affairs HSR&D merit
supplement, Laurel Copeland, PI] – approved and funded for FY09-FY10, $50,290
(10% as Co-I). Additional aim to examine differential mortality rates across
diagnostic groups with death index data.
Feasibility of Tracking OEF/IEF
Transition into VA Care [Veterans Affairs HSR&D special
short-term rapid response proposal, Laurel Copeland, PI] – approved and funded
for 2008, $35,600 (10% effort as co-I). Using VA administrative data, track
transition rates of soldiers leaving DoD and entering the VA healthcare system.
Incorporating Medicare Pharmacy Data
into an Analysis of Potentially Inappropriate Prescribing in Elderly Veterans
[Veterans Affairs HSR&D merit supplement IIR 06-062, Mary Jo Pugh, PI] –
approved and funded for FY09-FY11, $223,600 (10% as Co-I). Incorporate Medicare
pharmacy data into the analysis to better account for aging veteran population
with dual system use.
Potentially Inappropriate Prescribing
in Elderly Veterans [Veterans Affairs IIR-06-062,
Systematic Review and Tracking Database
for CPG Implementation Research [Veteran Affairs II-R, Valerie
Lawrence, PI] – approved and funded for 2003-2008, $735,400 (5% effort as
Co-I). Systematically review the literature on
organizational strategies of implementing evidence-based medicine into clinical
practice; designed to improve the quality of care provided to veterans with
QUERI diseases – high prevalence, chronic conditions (e.g., diabetes, CHF,
colon cancer, schizophrenia, depression, etc.)
Patterns
of Late-life Healthcare among VA patients with Schizophrenia
[Veteran Affairs IIR-05-326, Laurel Copeland, PI] – approved and funded for
2006-2008, $273,200 (20% effort as Co-I). Describe and analyze current patterns
of inpatient and outpatient medical, psychiatric, and other care for veterans
age 50+ with schizophrenia with or without diabetes; determine correlates of
care and relationship of patterns to mortality.
Improving substance abuse treatment in the borderland:
early intervention and follow-up in remote primary care clinics [Veteran Affairs
special funding RFP; Steve Holliday,
PI] – approved and funded for 2005-2007, ($736,990; 5%
effort as Co-I, donated time until October 2006). Provide substance
abuse interventions in a stepped care program for veterans in remote clinics
near the Mexico-Texas border. This demonstration project will seek out at-risk
veterans to engage them in treatment for substance abuse (alcohol, tobacco,
other drugs). The 3-year evaluated implementation project will augment and
integrate with clinical care currently being offered in three satellite clinics
in an impoverished, largely Hispanic population.
Implementing
integrated behavioral health care for predominantly Hispanic OEF/OIF veterans [Veteran Affairs special funding RFP; Steve Holliday, PI] –
approved and funded for 2005-2007, ($586,442; 5% effort as Co-I, donated time
until October 2006). Provide
comprehensive, integrated care for returning OEF/OIF veterans, including
screening and treatment for substance abuse (alcohol, tobacco, other drugs),
depression, PTSD, and medical care as well as job services. The target
population lives in an underserved region of
Improving Medication Adherence among
Veterans with Schizophrenia. [Veterans Affairs grant #IIR01-074-1;
Marcia Valenstein, PI] – approved and funded for 2001-2005, 30% effort as
research associate. Multi-site (4 VA) 18-month intervention study designed to
improve medication adherence among veterans with serious mental illness;
primary component was a simple blister-pak, with some pharmacy education and
provider notification of missed refills.
Adopting Best-practices in Community Settings: The ABCs
of Treatment for Schizophrenia. [funding from Texas Department of Mental
Health and Mental Retardation (TDMHMR) and AstraZeneca; Alexander Miller, PI. Invited to serve as consultant on funded project
examining an intervention (cognitive adaptation training) designed to improve
functioning and treatment adherence, reduce inpatient utilization, and minimize
jail experiences in low-income patients with schizophrenia. One significant
analysis will focus on the cost-effectiveness of this intervention (contributed
effort as consultant).
Advanced Center for Interventions and
Service Research (ACISR) for Optimizing Long Term Outcomes in Bipolar Illness
Interventions in Hispanic Communities (NIH proposal - UTHSCSA Department of
Psychiatry P30 – funded May 2011] – 1) Cultural
competency and reduced ethnic disparity in psychiatric diagnosis for a
predominantly Hispanic region (John Zeber, PI – 10% effort, contributed); 2)
Personalized Interventions to Improve Treatment Engagement (Adherence) in
Bipolar Disorder: Academic and Community Sites (Jodi Gonzalez, PI – 7% effort
as co-I contributed). The ACISR will strengthen interdisciplinary interventions
research in bipolar disorders with a focus on the needs of the Hispanic
American community. Working with the South Texas community of patient groups,
advocates, and mental health providers and with Case Western Reserve University
collaborators, the ACISR will advance treatment and research methods in
effective strategies focused on sustained benefit and healthy function. The
ACISR will work to improve patients’ management of their bipolar illness, and
to expand the career opportunities of young investigators, particularly for
underrepresented racial and ethnic groups. These efforts will equip us to serve
as a national resource to advance the NIMH mission of reducing the burden of
bipolar illness, improve outcomes through translational research and broad
dissemination, expand public education and facilitate optimal public health
planning.
UNDER
REVIEW/UNDER DEVELOPMENT
Adherence to Antipsychotic Medications
in a Community Health Ssystem and the Influence of Care Delivered via the Patient
Centered Medical Home. [NIDDK R01, submitted June 2011] –
Jane Bolin, PI (15% effort as co-I).
Comparison of Depression Interventions
for Acute Coronary Syndrome Patients (CODIACS II)
[NIH / NHLBI multi-site trial, to be submitted Fall 2011] – Karina Davidson, PI
(10% effort as site co-I). Multi-site trial to manage and reduce depression
symptoms in post-ACS cardiac patients via a standardized drug treatment
algorithm with randomized telemedicine psychotherapy component.
Evaluating the Feasibility to Measure
the Extent to Which Asthma Mortality Risk is Increased in ADVAIR Users (ASSESS
study) [Glasko Smith Kline and FDA, to be submitted July 2011] –
Richard Platt, PI (10% effort as site PI). Utilizing several sites from the
Developing Evidence to Inform Decisions about Effectiveness network (DeCIDE),
this FDA mandated, multi-site study will examine long-acting beta agonists
(LABA), inhaled corticosteroids (ICS), and mortality.
Improving Medication Adherence in
Schizophrenia: A comparison of two different technologies for improving
adherence; Electronic Monitoring and Cell Phone.
[VHA merit review proposal, to be submitted September 2011] - 25% effort as PI.
Centers for Education and Research on
Therapeutics (CERT IV multi-site center renewal) -
Scott & White participation as a secondary site: 1) Determinants of
Non-Initiation, Primary Non-Adherence, Early Non-Persistence and Ongoing
Adherence to Bisphosphonates for Osteoporosis; 2) Improving the Quality and
Safety of Opioid Use for Non-malignant Pain in the Elderly; 3) An RCT of
Targeting High Deductible Health Plan Enrollees with Consumer Reports Best Buy
Drugs Recommendations. [Agency for
Healthcare Quality and Research, submitted June 2011] – Richard Platt, lead PI;
5% total effort as site PI across all 3 studies]
Post-surgical Outcomes for
Traumatically Injured Military Patients (POTIMP) [Veterans
Affairs HSR&D merit proposal, resubmitted June 2011] – Laurel Copeland, PI
(20% effort as co-I). Traumatically injured solidiers are rarely the subject of
long-term study as comprehensive data collection is difficult to achieve.
Long-term outcomes are of interest because both amputation and limb salvage
have an immediate impact on life options, plus engender rehabilitation and
specialized healthcare needs over the remaining lifespan. Severe psychiatric
comorbidity likely accompanies trauma and limb loss from the current
Iraq/Afghanistan conflict, where deployment is associated with unprecedented rates
of stress reactions and affective disorders.
A unique collaboration between VA researchers and a DoD trauma surgery
research team will permit study of orthopaedic trauma surgery patients’
long-term outcomes and health services use in the VA.
Reports:
§
Blow FC, McCarthy JF, Valenstein M, Zeber
JE, Gillon L. “Care for VA Patients
with Psychoses, 1999-2003” – Part of team that developed the database and
co-author on detailed annual report (5 editions) of all VA patients with
serious mental illness (N=191,000): demographics, psychiatric and medical
comorbidities, cost, utilization, mortality, functional status, access, and
pharmacy fills.
Institution
and Research Community Contributions & Service / Teaching Efforts
Invited
Presentations / Expert Panels:
Veterans Affairs HSR&D Center of
Excellence, Houston – invited to present current research
findings at monthly seminar (June 2011)
International Workshop on Costs and
Assessment in Psychiatry, Mental Health Policy and Economics
– invited to chair an oral presentation session (May 2011).
Scott & White, Department of
Psychiatry Grand Rounds (January 2011)
Introduction to
faculty and students, with discussion of new research center (CAHR), our roles and
contributions, and possible collaborations. (invited speaker).
UTHSCSA Department of Psychiatry Grand
Rounds (December 2010)
Broad discussion
of current findings influencing poor medication adherence in patients with
serious mental illness, incluidng use of administrative versus primary data
collection, along with the clinical implications of targerting certain risk
factors. (invited speaker).
Returning
Introduction to
PTSD center, introudction of our health services projects pertaining to
post-deployment, transition into VA, and surgery studies. (invited speaker).
Scott & White, Department of
Medicine Grand Rounds (October 2010)
Introduction to
faculty and students, with discussion of new research center (CAHR), our roles
and contributions, and possible collaborations. (invited speaker).
Lead Guest Editor,
Depression Treatment and Research (in progress, from invitation to lead
a special issue for an upcoming journal supplement – Fall 2011).
Shared
preliminary findings of a local research project, surveys from patients and
clinicians at 6 clincs regarding post-deployment health issues, at the annual
meeting of primary care providers involved in a collective research network
(invited speaker).
Multiple risk
factors for poor medication adherence in veterans with schizophrenia and
bipolar disorder, including demographic, financial, and psychosocial issues;
based upon the literature and our own work with VA administrative and survey
data. (invited speaker).
Medication Adherence Expert Consensus
Guideline Panel (Fall 2008)
Invited
guest expert contributing to natinal working group project to identify risk
factors for madherence in patients with serious mental illness, and strategies
to address the persisent problem. Findings published in special supplement of Journal of Clinical Psychiatry (v70,
suppl 4, 2009).
Comprehensive Neuroscience Seminar on
Mental Illness and Pharmacy Benefits Policy (June 2007)
Special
sponsored seminar devoted to presenting research into the outcomes association
with medication copayments and other benefits for patients with psychiatric
conditions (invited speaker). Contributed to non-CME newsletters targeting
state and national mental health policy-makers.
Congressional Black Caucus / Center for
Minority Veterans: annual legislative meeting (September
21-23, 2005) Invited panelist for forum discussing the implications of ethnic
disparities in mental health diagnosis and treatment, designed to foster
research collaboration between VA, academic and other organizations.
Other Professional
Activities / Leadeship Roles / Contributed Effort:
Editorial Board, World Journal of
Psychiatry (May 2011 – present)
IRB committee member, Central Texas Veterans Health Care System,
member (May 2011 – present)
International Society for
Pharmacoepidemiology Outcomes Research (ISPOR) and ISPOR National Working Group
on Medication Compliance, member (2007 – present): co-facilitator of two special sections
examining initial compliance and the
effect of copayments / financial incentives.
Coordinator, VERDICT Research Forum (2007
– present): organized and led a weekly research seminar of internal
investigators and invited guest speakers.
Consultant, health services research
design and methods (2007 – present), several Practice Based Research Networks: StarNet (primary care
clinics), South Texas Psychitary (community psychiatrists), Veterans Affiars
mental health (VA providers), VA Women’s Research Network.
Consultant,
several university projects (2004 – present): unfunded participant role on
different studies led by Department of psychiatry investigators – study design
dicussions, defining variables and key outcomes, data analysis, manuscript
presentation (Drs. Miller, Velligan, Roache, Dassori, others).
Teaching,
mentoring, VA and university lectures, academic advisor roles:
Serving as mentor and consultant for
two younger clinicians transitioning into research and submitting VA career
devlopment porposals (Jack Tsan PhD; Eni Williams, PhD, PharmD), a resource for
VA pharmacy residents, and conducting a monthly seminar for junior Scott &
White clinical researchers.
Created and obtained funding for a new Scott
& White minority pre-doctoral fellowship (2 011-2012): interviewed
candidates, developed structured program of mentoring, coursework, meetings
with senior VA, hosptial, and academic leaders.
Volunteered to mentor a summer high
school research intern (2011), part of a funded project for an advanced junior
college training program.
Doctoral thesis / capstone project
committee member: Gordon Black,Frontier School of Nursing (Using the Health Promotion Model to Reduce
Appointment No-Shows in Rural Underserved Community Clinics).
Basic statistics / methods lecture on cost-benefit
and utility analyses for Scott & White pulmonary fellows (January 2011).
In addition to aforementioned SPH
course development, grand rounds and invited lectures, I have given numerous
informal local research presentations for VA and university colleagues, and
contribute 2-3 formal lectures on health services research methods as
part of a standing course in the univerisity’s Masters of Science in Clinical
Investigation program. (2009 – present).
Conferences
presentations:
May 2011: International Society for Pharmacoeconomics and
Outcomes Research (Baltimore) – A
Systematic Literature Review of Behavioral Risk Factors Associated with Initial
Medication Adherence (poster)
April 2011: International Conference of Schizophrenia
Research (Colorado Springs) – Surgical
Needs and Rates of Common Procedures in Patients with Serious Mental Illness (oral
presentation)
March 2011: HMO Research Network annual meeting (Boston) – Outcomes of Cardiovascular Events in Two
Systems of Care (poster)
March 2011: International Workshop on Costs and Assessment
in Psychiatry, Mental Health Policy and Economics (Venice, Italy) – Cost-Benefit Effects of Pharmacy Benefit
Policies in Patients with Schizophrenia (oral presentation)
February 2011: VA National Health Services Research &
Development Conference (Baltimore) – Medication
Adherence as a Measure of Comparative Effectiveness in Older Patients with
New-Onset Epilepsy (poster)
June 2010: Academy Health Annual Research Meeting (Boston,
MA) – 1) Cost-Related Medication
Adherence and Patients’ Experience with the Chronic Care Model (oral
presentation - Best Abstract, Quality & Efficiency theme; 2) OEF-OIF Post-Deployment Health Care
Needs in Community-based Primary Care Clinics (poster).
April 2010: VA National Health Services Research &
Development Mental Health Conference (
November 2009: National Association of Primary Care Research
Group Annual Meeting (
June 2009: Academy Health Annual Research Meeting (
June 2009: Critical Research Issues in Latino Mental Health
Conference (
March 2009: International Conference of Schizophrenia
Research (
February 2009: VA National Health Services Research &
Development Conference (Baltimore) – 1) A
Cost-Benefit Analysis of Higher Medication Copayments in Veterans with
Schizophrenia (oral presentation, plenary session); 2) Diabetes and Medication Adherence: Understanding the Association
between Perceived Drug Costs and Dimensions of the Therapeutic Alliance
(oral presentation); 3) Veterans with
Serious Mental Illness Undergoing Surgical Procedures: Prevalence Rates of
Preoperative Medical Comorbidities (poster).
October 2008: American Psychiatric Association 60th
Institute on Psychiatric Services (Chicago) – Addressing Barriers to
Effective Drug Treatment in Public Mental Health (symposium).
May 2008: International Society for Pharmacoeconomics and
Outcomes Research (Toronto) – 1) Medication
Adherence, Ethnicity, and the Influence of Multiple Psychosocial and Financial
Barriers (poster); 2) Ethnicity and
the Impact of Higher Medication Copayments among Veterans with Schizophrenia (poster
– received Best New Investigator top award);
3) The Cost-Offset Effect of a Copayment Increase among Veterans with
Schizophrenia (poster).
March 2008: Critical Research Issues in Latino Mental Health
Conference (
February 2008: VA National Health Services Research &
Development Conference (Baltimore) – 1) Medication
Adherence, Ethnicity, and the Influence of Multiple Psychosocial and Financial
Barriers in Veterans with Bipolar Disorder (oral presentation); 2) Cardiovascular Disease in Type-2 Diabetes:
Using the UKPDS Methodology to Determine Attributable Risk Variance Across 20
Community Clinics (poster); 3) Patient
Characteristics Affecting Perceived Access to Medical and Psychiatric Care in
Veterans with Bipolar Disorder (poster).
June 2007: Seventh International Conference on Bipolar
Disorder (Pittsburgh) – 1) Self-reported Access to Medical and
Psychiatric Care in Patients with Bipolar Disorder (oral presentation); 2) Therapeutic Alliance Perceptions and Medication
Adherence in Patients with Bipolar Disorder (poster).
March 2007: International Conference of Schizophrenia
Research (
February 2006: VA National Health Services Research &
Development Conference (Washington DC) – 1) Ethnicity,
Perceptions of Therapeutic Alliance, and Adherence in Patients with Bipolar
Disorder (oral presentation); 2)
Ethnicity and the Impact of Higher Medication Copayments among Veterans with
Schizophrenia (poster); 3) The Role
of Comorbid Psychiatric Conditions on Health Status in Veterans with Epilepsy (poster).
April 2005: International Conference of Schizophrenia
Research (
February 2005: VA National Health Services Research &
Development Conference (
June 2004: Academy Health Conference (San Diego) – 1) Atypical
Antipsychotics and Schizophrenia with Comorbid Substance Abuse; 2) Efforts to Recruit Patients with
Schizophrenia into Randomized Research Studies (posters).
May 2004: American Psychiatric Association conference (
February 2003: VA National Health Services Research &
Development Conference (Washington DC) – 1) The Role of Ethnicity in the Diagnosis of Veterans with
Serious Mental Illness (oral presentation); 2) Aging and Utilization Patterns among Veterans with Mental Illnesses
(poster).
June 2002: Academy Health Conference (
April 2002: National
February 2002: VA National Health Services Research &
Development Conference (
September 2001:
February 2001: VA National Health Services Research &
Development Conference (
June 2000: Academy Health Conference (
Ad-hoc Journal Reviewer:
American Journal of Preventive Medicine (March 2008 – present), Scandinavian Journal of Public Health (March 2008 –
present), Comprehensive Psychiatry (December
2007 – present), Canadian Medical Journal
(September 2007 – present); Acta
Neuropsychiatrica (June 2007 – present); Diabetes Care (May 2007 – present); Journal of General Internal Medicine (April 2007 – present); Healthcare Management Review (May 2006
– present); Clinical Therapeutics
(September 2007 – present); Journal of
Behavioral Health Services & Research (March 2006 – present); Patient Education and Counseling
(February 2006 – present); Bipolar
Disorder (May 2005 – present); Medical
Care (December 2002 – present); American
Journal of Managed Care (March 2001 – present)
Scholarships,
Fellowships and Awards:
Ø Best
Abstract for Quality & Efficiency: Improving Processes of Care theme,
Academy Health 2009 - Cost-Related Medication Adherence and Patients’
Experience with the Chronic Care Model.
Ø Best
New Investigator poster, ISPOR 2008 - Ethnicity and the Impact of Higher
Medication Copayments among Veterans with Schizophrenia.
Ø Agency for Health Care Policy and
Research (ACHPR) Fellowship – National Service Research Award,
University of Michigan, 1998-2000.
Ø Alumni Scholarship
– MHA program,
Ø First Interstate Scholarship
/ Dean’s List / Los Angeles Philanthropic Society Scholarship –
Ø Scholar-Athlete Award Finalist
–
Ø Most Valuable Player,
Most Inspirational – Intercollegiate
tennis:
Professional
Membership and Activities:
¨
American
Society of Hispanic Psychiatry, member (2008 – present)
¨
Academy
of Health Services Research, member (2002 – present)
¨
International
Society for Pharmacoeconomics & Outcomes Research
(ISPOR), member (2005 – present)
¨
Leadership
Committee -- MHA Program,
Peer-elected as Co-facilitator of the student run student organization. Full responsibility for overseeing and coordinating various sub-committees including budget and fundraising, orientation, graduation functions, student and professional mentor activities, and academic seminars. Also assisted with curriculum changes and admissions.
¨
Assisted in
developing the itinerary for a two-week comparative study experience of the
Norwegian healthcare system, September 1997. Included, among others, were
visits to the National Health Ministry, a for-profit hospital, a rural health
system, and an occupational health program. Helped draft funding proposal and
solicited financial support from the