Dr. Cyril Chang publishes five articles this year in various medical journals

For release:  November 1, 2016

Dr. Cyril Chang, professor of Economics and director of Methodist Le Bonheur Center for Healthcare Economics, has recently published or has received acceptance for five of his articles in various medical publications.

The first article will be published in Women's Health Issues and it is entitled "Does Cost-Related Medication Non-adherence among Patients with a Cardiovascular Disease Depend on Gender? Evidence from a National Representative Sample." Dr. Chang co-authored this article with Drs. Soumitra Bhuyan and Satish Kedia, both of the University of Memphis School of Public Health.

Cardiovascular disease (CVD) conditions are a leading cause of death and disability as well as a major burden on the US healthcare system. Cost-related medication non-adherence (CRN) to prescribed medications is common among patients with CVD. This study examines the gender differences in CRN to medications among CVD patients.

His second article is to be published in American Health & Drug Benefits. The article is entitled "Effects of Specialty Pharmacy Care on Health Outcomes in Multiple Sclerosis." Dr. Chang co-authored this article with Dr. Jun tang, research analyst at Lundbeck, and Dr. Jim Bailey, professor of medicine at the University of Tennessee Health Science Center.

Multiple sclerosis (MS) is a chronic, debilitating disease that attacks the central nervous system. In the United States, approximately 400,000 people are living with MS, with 10,400 people being newly diagnosed with MS each year. This study's primary objective was to compare the risk of relapse in MS patients receiving specialty pharmacy care with those receiving treatment through usual community pharmacy care during the study period. The second objective was to assess the impact of patient's demographics, comorbidity, and index medication on MS clinical outcomes. Specialty pharmacy care was associated with significantly lower risk of developing MS relapses (specifically the first relapse) and fewer MS relapses compared to usual community pharmacy care.

The third article published in the Journal of Medical Systems is entitled "Too Much or Too Little? How Much Control Should Patients Have over EHR Data?" Dr. Chang co-authored this article with Dr. Sumitra Bhuyan, assistant professor at the University of Memphis School of Public Health, Ms. Sandra Bailey-DeLeeuw, doctoral student at the University of Memphis School of Public Health and a VP at Methodist Le Bonheur Healthcare, and Dr. David Wyant, assistant professor of Management at Belmont University.

Electronic health records (EHRs) have been promoted as a mechanism to overcome the fragmented healthcare system in the United States. The authors suggest in this paper that the ongoing policy discussion include consideration of the precise questions patients will be asked when a need for data sharing arises. Furthermore, patients should understand the relative risks that they face, and the degree to which their decisions will significantly reduce the risk of a data breach. As various approaches are considered, it is important to address the relative resource requirements and the associated costs of each option.

The fourth article was also published in the Journal of Medical Systems and it is entitled "Use of Mobile Health Applications for Health-Seeking Behavior Among US Adults." Dr. Chang co-authored this article with Drs. Soumitra Bhuyan and Satish Kedia, both of the University of Memphis School of Public Health.

This study explores the use of mobile health applications (mHealth apps) on smartphones or tablets for health seeking behavior among US adults. Data was obtained from cycle four of the 4th edition of the Health Information National Trends Survey (HINTS 4). Weighted multivariate logistic regression models were examined to explore the effects of 1) having mHealth apps, 2) usefulness of mHealth apps in achieving health behavior goals, 3) helpfulness in medical care decision-making, and 4) asking a physician new questions or seeking a second opinion. The multivariate models revealed that respondents were more likely to have mHealth apps if they had more education, health insurance, were confident in their ability to take good care of themselves, or had comorbidities, and were less likely to have them if they were older, had higher income, or lived in rural areas.

Dr. Chang's fifth article was published in the American Journal of Emergency Medicine and it is entitled "Paid sick leave is associated with fewer emergency department visits among U.S. private sector working adults." This article was co-authored by Dr. Sumitra Bhuyan, assistant professor at the University of Memphis School of Public Health, and Dr. Jay Bhatt, Feinberg School of Medicine at Northwestern University.

This study used a multiyear nationally representative database to examine the association between availability of paid sick leave and frequency of emergency department (ED) use among U.S. private sector employees. Results suggest that availability of paid sick leave is significantly associated with lower likelihood of ED use, for both moderate (1-3 times/year) and repeated users (4 or more times/year). After controlling for confounding factors, respondents with paid sick leave are 14% less likely to be moderate ED users (AOR: 0.86, 95% CI: 0.79-0.93) and 32% less likely to be repeated ED users (AOR: 0.68, 95% CI: 0.50-0.91).