Professor Mullins currently is involved in a number of research projects focused on pharmacoeconomics, comparative effectiveness research (CER), patient-centered outcomes research (PCOR), and health disparities research. For quick navigation, please use the index below.
PATIENTS: PATient-centered Involvement in Evaluating effectivNess of Treatment
PATIENTS combines the expertise of leading researchers from the University of Maryland, Baltimore and the University of Maryland, College Park in partnerships with health care systems and patient communities and advocacy groups to improve health care research and outcomes. Our researchers are committed to working with partners in the community to address real-world concerns and identify and meet the needs of the patients we serve. More information on PATIENTS may be found on the official website here.
VIDEO: An overview of the PATIENTS program
ALPHA-1 ANTITRYPSIN DEFICIENCY (Alpha-1) COST STUDY
The objective of this study is to evaluate the costs of Alpha-1 treatment in a general population and among individuals with Alpha-1 whom participate in a disease management program designed for patients with Alpha-1 and their healthcare providers. The cost estimates will be used to model the budgetary impact of implementing an Alpha-1 disease management program.
An example of such a program is the Alpha-1 Disease Management and Prevention Program (ADMAPP), offered by AlphaNet, a non-profit organization which aims to treat the disease, improve quality of life and manage health resources utilized by individuals with Alpha-1, as well as their families and healthcare providers. The program itself consists of six integral components: 1) a guide for persons with Alpha-1 and healthcare providers, so-called the “Big Fat Reference Guide”; 2) a comprehensive health outcome study started on January 1, 2003, currently following more than 1,000 persons with Alpha-1; 3) a unique telemonitoring system; 4) a nationally recognized education program for nurses; 5) a treatment planning and review process; and 6) the Disease Management Advisory Committee (DMAC), consisting of international experts.
This study will quantify costs associated with Alpha-1 and the budget impact of an Alpha-1 an Alpha-1 high-quality care/disease management program in current dollars.
Current Projects As Collaborator
Health Enterprise Zone (PI: Ross S)
Prof. Mullins is collaborating with the West Baltimore Primary Care Access Collaborative (WBPCAC) on the recently state-awarded Health Enterprise Zone (HEZ) project coordinated by the Maryland Community Health Resources Commission (CHRC). To assure success, an evaluation of the collective impact of the WBPCAC HEZ on member institutions is incorporated in the evaluation plan. Prof. Mullins will be leading a team of program evaluation experts to provide monitoring and evaluation oversight for the project aims.
REPORT: Coverage on HEZ from The Baltimore Sun
Solving the state’s health disparities
More information on this project may be found on the official website here.
Information on the Maryland statewide initiative may be found on the official website here.
Maryland Health Care for All! Coalition (PI: DeMarco V)
Recently, the state created a new system to motivate your local hospital to work more closely with all the other care providers in your community. The goal is to make the whole system work better for you and your family. In its role in protecting the public’s interest, the Maryland Health Services Cost Review Commission (an independent state agency) is helping providers to adjust to this new model and is working with hospitals to ensure high quality care.
The activities contracted to University of Maryland will employ the expertise of Professor C. Daniel Mullins, a nationally-recognized expert in community-based program evaluation, health disparities, patient- centered research, and health economics. Professor Mullins (with assistance from Lynn Disney, Hillary Edwards and Corliss Heath from UMB) will oversee the overall FCHN Project Internal Evaluation activities, including provision of oversight and technical assistance for Reporting, Progress Monitoring, Program Management and Guidance.
The University of Maryland will provide scientific consultation to the Maryland Citizens’ Health Initiative Education Fund, Inc. (MCHI) to evaluate the impact, effectiveness, and efficiency of a 2 year pilot of the FCHN at LifeBridge Health hospitals including Carroll Hospital Center, Northwest Hospital and Sinai Hospital. The FCHN aims to build collaboration across hospitals and trained faith community partners, to positively impact health outcomes of ailing congregants and community members and support achievement of the goals of Maryland’s unique all-payer waiver.
Pragmatic Randomized Trial of Proton vs. Photon Therapy for Patients with Non-Metastatic Breast Cancer Receiving Comprehensive Nodal Radiation: A Radiotherapy Comparative Effectiveness (RADCOMP) Trial (PI: Bekelman J)
The PATIENTS Program is working with University of Pennsylvania to incorporate patient and other stakeholder voices in the design and implementation of a clinical trial. This five-year, PCORI-funded, $11.8 million pragmatic randomized trial compares two forms of radiation therapy (PRoton versus PHoton therapy) in patients with breast cancer. The primary outcome is major cardiovascular events, since radiation therapy aimed at breast tissue can hit other neighboring organs, such as the heart. Other outcomes include cancer control and health-related quality of life.
The PATIENTS Program’s role in this trial is to lead patient and stakeholder engagement activities, to ultimately ensure that patient and stakeholder opinions shape how the trial is performed. We have already identified and recruited a Stakeholder Advisory Committee of stakeholders, including patients, patient advocacy groups, payers, federal agencies, and physician groups. These advisors give feedback on recruitment and retention strategies, outcomes the trial should measure, and how to disseminate result findings in a meaningful way to patients and other stakeholders.
Engaging Caregivers Across the Lifespan: Activating Communities to Become Partners in Health Research (PI: dosReis S)
The purpose of this contract is to: 1) Identify treatment priorities around care management decisions; 2) Identify gaps in delivery of services or interventions that could be most effective; 3) Identify meaningful outcomes for caregivers, care recipients and families; 4) Disseminate information that improves decision making among caregivers and care recipients.
These goals will be achieved by employing the following approaches to engage the voice of caregivers in different ways: as active partners on the research advisory team; as active participants in the research study; as contributors to the materials for dissemination; as end users of dissemination materials.
As a result, this project will give back to the community by engaging caregiver and patient investigators to give families a voice in research, as well as generate information that will be useful to other caregivers, clinical providers, consumer organizations, and state agencies.
Recently Completed Projects As Principal Investigator
Implications of Bayesian Adaptive Trials on Comparative Effectiveness Research
This project involves an innovative approach to designing and conducting “pragmatic” randomized clinical trials (RCTs) for comparative effectiveness research (CER) in cardiovascular disease. Funding for this project is provided by the NIH/NHLBI.
VIDEO: Prof. Mullins discusses his project on Bayesian Adaptive Trials.
PCORI-funded Research on Engaging Hard-to-Reach Patients in CER and PCOR
NEWS: Daniel Mullins, PhD, led an interprofessional team from pharmacy, medicine, and nursing, collaborating with community groups, to reach potential patients.
Report from SOP Tells How to Include Hard To Reach Patients.
This report is aimed at encouraging medical researchers to include “hard-to-reach” patients in future studies and clinical trials. It summarizes its findings into “10 Solid Suggestions How to Elicit Hard-to-Reach Patients’ Perspectives and Partner with Patient Communities”.
The findings presented in this report are the result of a six-month study led by Dr. Mullins and the University of Maryland School of Pharmacy that involved dozens of focus groups of caregivers and patients of different medical conditions. Funding was provided from Dr. Mullins’ unique contract with the Patient-Centered Outcomes Research Institute (PCORI), an independent agency established by the federal Affordable Care Act of 2010 as a non-governmental, nonprofit organization.
The original official report in PDF format may be accessed here.
Outcomes Research on Colon Cancer Treatments Using SEER-Medicare Dataset
The goal of the project is to examine treatment patterns and outcomes among pretreated elderly Medicare colon cancer patients who progress to 2nd and 3rd line chemotherapy treatment. Funding for this project is provided by Bayer HealthCare Pharmaceuticals, Inc.
Professor Mullins’ group has published several papers using SEER-Medicare, including an algorithm for identifying treatment lines – see PubMed page here for the algorithm paper. For a complete list of Professor Mullins’ publications, click on the Publications link.