My research has focused on development of behavioral interventions to improve outcomes after lung transplantation. I am currently develoing a health literacy-sensitive decision aid that helps patients with severe COPD choose between lung transplantation and medical management with the ultimate goal of reducing decisional conflict, improving self-efficacy and improving post-surgical outcomes. My background has prepared me to conduct this current study by: 1) gaining clinical experience in the field of lung transplantation as a lung transplant pulmonologist, 2) developing and implementing clinical research studies by obtaining my Masters degree in Epidemiology, and 3) conducting studies in health literacy, organ allocation, and decision making.
Health literacy: I am currently developing a health-literacy sensitive tool to improve medical adherence in lung transplant recipients. We have administered a survey and performed chart abstraction on 141 lung transplant recipients to understand how medical adherence mediates the relationship between health literacy and critical post-transplant outcomes. We have also conducted qualitative interviews with patients and their caregivers that were purposefully sampled patients for low health literacy to understand facilitators and barriers of medical adherence after transplantation. After we reach our targeted sample size of 200, we will use the results of the qualitative and quantitative study to develop a health literacy-sensitive intervention to improve adherence.
Organ Allocation: I published a manuscript on the impact of the lung allocation score (LAS) on listing diagnoses transplanted and post-transplant survival. I have also published a manuscript that used time depended ROC curves to show that our current lung allocation system predicts survival no better than flipping a coin. Finally, I have developed a lung allocation model using recursive partitioning that takes into account survival differences of different diagnoses.
Decision Making: I have experience with studying satisfaction with decision making regarding end-of-life issues in the ICU. I have published my results that showed that increased family satisfaction with decision making was associated with withdrawing life-support and documentation of palliative care indicators.