Steven Erickson, Pharm.D.
Affiliated Research Faculty
Steven Erickson, Pharm.D.
|1980||B.S.||Ferris State College|
|1984||Pharm.D.||Wayne State University|
My background as a researcher and clinical pharmacist allow me to bring a unique perspective to the development and implementation of the research. I have over twenty-five years of practice experience as a clinician working with patients in adult general internal medicine practices and clinics. My focus has always been to ensure the appropriate prescribing and utilization of medications for patients. First and foremost has been my research on identifying reasons for medication nonadherence, testing various methods to understand and measure medication taking behavior, and developing intervention studies to improve medication utilization. As my research has progressed I have identified a target group, persons with disabilities that are in dire need of assistance with medication utilization. I have now expanded and targeted my current research focus to ensuring the safe and effective use of medications by people with disabilities and feel my contributions will provide key benefits to their health and well-being. After completing a sabbatical leave at Wayne State University Developmental Disabilities Institute, I initiated several research projects to better understand how people with intellectual/developmental disabilities (IDD) and their caregivers utilize and administer medications. I also recently partnered with researchers who utilize large administrative datasets to describe medication utilization by people with IDD. An important related focus of work has been partnering with investigators to develop interventions to improve the cultural competence of health care professionals working with people who have disabilities. Future expected work includes studying the issues that people with disabilities and their support network (caregivers) have with the medication use process; examine the association between health literacy and the ability to perform medication administration tasks; and to study individual and social factors associated with medication self-management or supported self-management. The current application builds logically on my prior work as feel as my added research focus and goals.
1. My early research focused on the use of patient reported outcomes as a measure of health and influence of health-care interventions. Much of that work focused on studying the association between patient, disease, and treatment variables with outcomes such as functional status, well-being, satisfaction, health-related quality of life and presenteeism. The greatest contribution of this work was to validate the association between symptoms and functional status, or health-related quality of life. T has served as a foundation for studies that have further assessed the relationship between symptoms and functioning in other fields.
a. Erickson SR, Williams BC, Gruppen LD. Perceived symptoms and health-related quality of life reported by uncomplicated hypertensive patients compared to normal controls. J Human Hyperten 2001;15:539-548.
b. Erickson SR, Williams BC, Gruppen LD. Relationship between symptoms and health-related quality of life in treated hypertensive patients. Pharmacotherapy 2004;24:344-350.
c. Ellis JJ, Eagle KA, Kline-Rogers EM, Erickson SR. Depressive symptoms and treatment after acute coronary syndrome. Intern J Cardiol 2005;99:443-447.
2. As my work continued I was developing and studying multivariate models to identify patient and treatment variables associated with various general patient reported outcome measures such as the SF-36. When adjusting for the potential influence of comorbidities, it occurred to me that no comorbidity or risk-adjustment index existed for studies where the dependent variable is a general health-related quality of life measure. Working with an experienced statistician and several graduate students, I lead a study to create and tested such an index. The result is the Health-Related Quality of Life Comorbidity Index. I continued this work directly with Dr.Ou to refine the index. Following that, I explored other areas for improvement of predictive modeling and risk adjustment, focusing on cardiovascular disease.
a. Mukherjee B, Ou H, Wai F, Erickson SR. A new comorbidity index: the health-related quality of life comorbidity index (HRQL-CI). J Clin Epid 2011;64:309-319.
b. Ou HT, Erickson SR, Mukherjee B, Bagozzi R, Piette JD, Balkrishnan R. Comparative performance of comorbidity indices in discriminating health related behaviors and outcomes. Health Outcomes Research in Medicine 2011;2:e91-e104.
c. Ou HT, Erickson SR, Mukherjee B, Bagozzi R, Piette JD, Balkrishnan R. Comparative performance of comorbidity indices in predicting healthcare related behaviors and outcomes among Medicaid enrollees with type-2 diabetes. Population Health Management 2012;15:220-229.
d. Erickson SR, Cole E, Kline-Rogers E, Eagle KA. The addition of the Charlson Comorbidity Index to the GRACE Risk Prediction Index improves prediction of outcomes in Acute Coronary Syndrome. Population Health Management 2014;17: DOI:10.1089/pop.2012.0117
3. Throughout my research career I’ve worked to identify reasons for medication nonadherence, testing various methods to measure medication taking behavior, and to develop intervention studies to improve medication utilization. The results of a number of the studies helped to confirm that patient-self reported adherence measures are capable of identifying patients who are nonadherent to medicastion therapy. Another contribution was the study by Ellis, et al, in which we clearly demonstrated the negative association between higher cost copays for medication and lower adherence. The senior author of that paper has used it and others to promote the concept of value-based insurance design.
a. Erickson SR, Coombs JH, Kirking DM, Azimi AR. Compliance from self-reported versus pharmacy claims data with metered-dose inhalers. Ann Pharmacother 2001;35:997-1003.
b. Ellis JJ, Erickson SR, Stevenson JG, Bernstein SJ, Stiles RA, Fendrick AM. Sub-optimal statin adherence and discontinuation in primary and secondary prevention populations: Should we target patients with the most to gain? J Gen Intern Med 2004;19:638-645.
c. Garber MC, Nau DP, Erickson SR, Aikens JE, Lawrence JB. The concordance of self-report with other measures of medication adherence: a summary of the literature. Med Care 2004;42:649-652.
d. Sud A, Kline-Rogers EM, Fang J, Armstrong D, Rangarajan K, Otten R, Stafkey D, Eagle KA, Taylor S, Erickson SR. Adherence to medications in patients discharged with Acute Coronary Syndrome. Ann Pharmacother 2005;39:1792-1797.
4. More recent contributions in the area of assessing adherence and access to medications incorporates population-based assessments. My recent research sought to identify whether disparities in the access to essential pharmacy services and medications exist based on where people live and their associated sociodemographics. This study clearly demonstrated that within a diverse county such as Wayne County, which incorporates the metropolitan Detroit area, disparities do exist along sociodemographic divisions in the availability of immunizations, cost of medication, and hours of operation. Further unique and novel research that I’ve conducted is an assessment of the spatial factors associated with medication adherence. Working with the largest insurer in Michigan, I was able to map medication taking behavior in the form of medication possession ratios for statin drugs using pharmacy claims data at the ZIP code level. Further spatial analysis found distinct patterns of high and low adherence. The significance of this work is that there may be locally relevant reasons for variation in adherence which are not accounted for in usual assessments of adherence. Through this research I have identified reasons for variation in adherence which have not previously been accounted for in usual assessments. This information has been presented at several national research meetings and in through my publications so that other researchers can be sure to include these aspects in their research. This will allow for more robust intervention methods that will provide better patient improvement in medication adherence and better quality of life.
a. Hoang C, Kolenic G, Kline-Rogers E, Eagle KA, Erickson SR. Mapping medication taking behavior of patients discharged for the treatment of acute coronary syndrome. Pharmacotherapy 2011;31:927-933.
c. Services provided by community pharmacies throughout Wayne County, Michigan. A comparison by ZIP code characteristics. J Am Pharm Assoc 2014;54: 618-624.
Ongoing Research Support
No number. (Research Grant Agreement 324003)
Craig H. Neilsen Foundation
Teaching Healthcare Providers to Facilitate Self-Management Skills in patients with Spinal Cord Injury.
The goal of this project is to develop educational modules to teach clinicians about medication self-management concepts for patients with spinal cord injury.
United States Department of Education
Technology Increasing Knowledge: Technology Optimizing Choice (TIK-TOC)
The goal of this project is to develop health self-management skills for young adults with neurodevelopmental disabilities and their caregivers using various technologies. The subproject in which I participate will develop supportive messages and information around medication management that will be utilized by reinforcement learning to impact medication management. The messages and information will be tested using an RL-adaptive visual and interactive application.
Detroit URC Community Participatory
Research Grant-Partnership Development
The goal of this project is identify health-related issues that warrant further investigation for residents of Detroit who have intellectual/developmental disabilities and who are enrolled with the Detroit Wayne Mental Health Authority.
Completed Research Support
Developing a comorbidity index for health-related quality of life studies.
The goal of this project was to develop a comorbidity index that is composed of diagnoses know to impact health-related quality of life. The intention is that it be used as the standard risk adjustment measure for studies in which health-related quality of life is the primary dependent variable of interest.
Michigan Institute for Clinical and Health Research (MICHR) Seed Grant
Health literacy of caregivers of adults with developmental disabilities
The goals of the project were to assess the health literacy of caregivers of adults with intellectual/developmental disabilities and to assess the association between health literacy and medication management.
Professional Memberships & Honors
1990- American Association of Colleges of Pharmacy (AACP)
1995- International Society for Pharmacoeconomic and Outcomes Research (ISPOR)
1999 AHCPR Collateral Reviewer, Small Project Grants
2000 Department of Defense, Congressional Interest Research on Health-related Topics Peer Review Panel, American Institute of Biological Sciences, peer reviewer
2009 American Heart Association, Behavioral Sciences and Epidemiology Study Section, Peer Reviewer.
2011-2012 NIH Review Panel Small Business: Risk Prevention and Health Behavior.
2011-2012 Expert Panel Member, RAND Corporation: Development of a New Asthma-Specific Quality of Life Measure.
2014- American Academy of Developmental Medicine and Dentistry (AADMD)
2014- American Association on Intellectual and Developmental Disability (AAIDD)
1984 Sandoz Research Award, Wayne State University Pharm.D. Program
2015 University of Michigan College of Pharmacy Student Appreciation Award
2015 University of Michigan, Council for Disability Concerns, Certificate of Appreciation