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Central Nervous System and Behavioral Health Research

The CNS/BH team has over 40 years of clinical and research experience to produce data-based evidence with robust study design and execution.


Proven research expertise

CNS/BH researchers come from diverse disciplines ― social work, health services research, applied economics, family social science ― and have expertise with retrospective claims and electronic health record data and with primary data collected via medical chart or survey.

Examples of research topics include pain and opioids, multiple sclerosis, Alzheimer’s disease and dementia, insomnia, migraine, epilepsy and seizure, depression and bipolar disorder. We publish study results in managed care, pharmacotherapy and clinical journals.

Examples of retrospective claims data projects

  • Adjunctive therapy in depression
  • Impact of health plan cost-saving program on pregabalin use and health care costs
  • Evaluation of guideline-recommended pain medication use in patients with newly diagnosed fibromyalgia

Examples of retrospective EHR data projects

  • Analysis of agitation in patients with Alzheimer’s disease or dementia by disease severity
  • Linked claims and EHR analysis in depression
  • Linked claims and EHR study validating lupus diagnosis codes in claims data

Examples of claims data-linked primary care projects

  • Medical chart abstraction to validate claims algorithm to identify multiple sclerosis relapse
  • Claims-linked survey of association between cognitive function and health care costs after antidepressant initiation

Alexander JK, Ariely R, Wu Y, Hulbert E, Bryant A, Su Z, Vardi M, Kasturi J. Treatment patterns following initiation of generic glatiramer acetate among patients with multiple sclerosis from two large real-world databases in the United States. Curr Med Res Opin. 2021 Aug;37(8):1323-1329. doi: 10.1080/03007995.2021.1929135. Epub 2021 Jun 7.

Martin C, Koep E, White J, Belland A, Waters H, Forma F. Treatment compliance communications between patients with severe mental illness and treating healthcare providers: A retrospective study of documentation using healthcare reimbursement claims and medical chart abstraction. Pragmat Obs Res. 2021;12:49-63.

Forma F, Koep E, White J, Belland A, Waters H, Martin C. Impact of treatment-related discussions on healthcare resource use and costs among patients with severe mental illness. Curr Med Res Opin. 2021 Oct;37(10):1799-1809. doi: 10.1080/03007995.2021.1943341. Epub 2021 Jul 23.

Fang J, Johnson J, Cheadle MA, Shar R, Ferraris M, Lopez Lopez C. Real-world trends in characteristics of migraine patients newly initiated on erenumab in the United States: A retrospective analysis. Adv Ther. 2021 Jun;38(6):2921-2934. doi: 10.1007/s12325-021-01677-y. Epub 2021 Mar 24.

Frazer M, Abler V, Halpern R, Skoog B, Rashid N. Burden of illness among patients with dementia-related psychosis. J Manag Care Spec Pharm. 2021 Mar;27(3):367-378. doi: 0.18553/jmcp.2021.27.3.367.

Cisternas M, Bartolome L, Gitar B, Hulbert E, Trenz H, Patel V, Johnson K, Russo PA. Health care resource utilization and disease modifying treatment use in multiple sclerosis patients by age and insurance type. Curr Med Res Opin. 2021 Apr;37(4):597-604. doi: 10.1080/03007995.2021.1885367. Epub 2021 Feb 26.

Nicholas J, Halpern R, Ziehn M, Peterson-Brandt J, Leszko M, Deshpande C. Real-world cost of treatment for multiple sclerosis patients initiating and receiving infused disease-modifying therapies per recommended label in the United States. J Med Econ. 2020 Aug;23(8):885-893. doi: 10.1080/13696998.2020.1761821. Epub 2020 May 18.

Halpern R, Seare J, Tong J, Hartry A, Olaoye A, Aigbogun MS. Using electronic health records to estimate the prevalence of agitation in Alzheimer disease/dementia. Int J Geriatr Psychiatry. 2019 Mar;34(3):420-31.

Ng-Mak D, Halpern R, Rajagopalan K, Loebel A. Hospitalization risk in bipolar disorder patients treated with lurasidone versus other atypical antipsychotics. Curr Med Res Opin. 2019 Feb;35(2):211-19.

Kalilani L, Halpern R, Seare J, Dedeken P. The challenges of assessing effectiveness of lacosamide using electronic medical record databases. Epilepsy Behav. 2018;85:195-99.

Espay AJ, Trosch R, Suarez G, Johnson J, Marchese D, Comella C. Minimal clinically important change in the Toronto Western Spasmodic Torticollis Rating Scale. Parkinsonism Relat Disord. 2018 Jul;52:94-97.

Engel-Nitz NM, Boscoe A, Wolbeck R, Johnson J, Silvestri NJ. Burden of illness in patients with treatment refractory myasthenia gravis. Muscle Nerve. 2018 Feb 27;58:99-105.

Williams MJ, Johnson K, Trenz HM, Korrer S, Halpern R, Park Y, Herrera V. Adherence, persistence, and discontinuation among Hispanic and African American patients with multiple sclerosis treated with fingolimod or glatiramer acetate. Curr Med Res Opin. 2018 Jan;34(1):107-15.

Tohen M, Ng-Mak D, Rajagopalan K, Halpern R, Chuang CC, Loebel A. Patient characteristics associated with use of lurasidone versus other atypical antipsychotics in patients with bipolar disorder: Analysis from a claims database in the United States. Prim Care Companion CNS Disord. 2017 Jun;19(3).

McIntyre RS, Ng-Mak D, Chuang C, Halpern R, Patel PA, Rajagopalan K, Loebel A. Major depressive disorder with subthreshold hypomanic (mixed) features: A real-world assessment of treatment patterns and economic burden. J Affect Disord. 2017 Mar 1;210:332-37.

Halpern R, Shah S, Cappelleri JC, Masters ET, Clair A. Evaluating guideline-recommended pain medication use among patients with newly diagnosed fibromyalgia. Pain Pract. 2016 Nov;16(8):1027-39.

Martin C, Odell K, Cappelleri J, Bancroft T, Halpern R, Sadosky A. Impact of a novel cost-saving pharmacy program on pregabalin use and health care costs. J Manag Care Spec Pharm. 2016 Feb;22(2):132-44.

Walker V, Patel H, Kurlander JL, Essoi B, Yang J, Mahableshwarkar AR, Samp JC, Akhras KS. Association between cognitive function and health care costs 3 months and 6 months after initiating antidepressant medication for depressive disorders. J Manag Care Spec Pharm. 2015 Sep;21(9):742-52.

Caraway D, Walker V, Becker L, Hinnenthal J. Successful discontinuation of systemic opioids after implantation of an intrathecal drug delivery system. Neuromodulation. 2015 Aug;18(6):508-15.

Buikema A, Halpern R, Shah S, Odell K, Alvir J, Hulbert E, Whiteley J. Impact of co-payment discounts on antidepressant medication adherence and costs. Am J Pharm Benefits. 2015 June;7(3):136-43.

Jain A, Marshall J, Buikema A, Bancroft T, Kelly JP, Newschaffer CJ. Autism occurrence by MMR vaccine status among US children with older siblings with and without autism. JAMA. 2015 Apr;313(15):1534-40.

Kahle-Wrobleski K, Fillit H, Kurlander J, Reed C, Belger M. Methodological challenges in assessing the impact of comorbidities on costs in Alzheimer’s disease clinical trials. Eur J Health Econ. 2014 Dec;16(9):995-1004.

Chang TE, Jing Y, Yeung AS, Brenneman SK, Kalsekar ID, Hebden T, McQuade RD, Baer L, Kurlander JL, Watkins AK, Siebenaler JA, Fava M. Depression monitoring and patient behavior in the clinical outcomes in measurement-based treatment (COMET) trial. Psychiatr Serv. 2014 Aug;65(8):1058-61.

Ettinger A, Good M, Manjunath R, Faught E, Bancroft T. The relationship of depression to antiepileptic drug adherence and quality of life in epilepsy. Epilepsy Behav. 2014 Jul; 36:138-43.

Jain A, Spencer D, Yang W, Kelly JP, Newschaffer CJ, Johnson J, Marshall J, Azocar F, Tabb LP, Dennen T. Injuries among children with autism spectrum disorder. Academic Pediatrics. 2014;14(4):390-97.

Kauf TL, Svatek RS, Amiel G, Beard TL, Chang SS, Fergany A, Karnes RJ, Koch M, O’Hara J, Lee CT, Sexton WJ, Slaton JW, Steinberg GD, Wilson SS, Techner L, Martin C, Moreno J, Kamat AM. Alvimopan, a peripherally acting μ-opioid receptor antagonist, is associated with reduced costs after radical cystectomy-economic analysis of a phase 4 randomized, controlled trial. J Urol. 2014 Jun;191(6):1721-27.

Burke JP, Jain A, Yang W, Kelly JP, Kaiser M, Becker L, Newschaffer CJ. Does a claims diagnosis of autism mean a true case? Autism. 2014 Apr;18(3):321-30.

Clements KM, Skornicki M, O’Sullivan AK. Cost-effectiveness analysis of antiepileptic drugs in the treatment of Lennox-Gastaut syndrome. Epilepsy Behav. 2013 Oct;29(1):184-89.

Halpern R, Gillard P, Graham GD, Varon SF, Zorowitz RD. Adherence associated with oral medication in the treatment of spasticity. PM R. 2013 Sep;5(9):747-56.

Halpern R, Nadkarni A, Kalsekar I, Nguyen H, Song R, Baker R, Nelson JC. Medical costs and hospitalizations among patients with depression treated with adjunctive atypical antipsychotic therapy: An analysis of health insurance claims data. Ann Pharmacother. 2013 Jul;47(7-8):933-45.

Johnson P, Becker L, Halpern R, Sweeney M. Real-world treatment of post-herpetic neuralgia with gabapentin or pregabalin. Clin Drug Investig. 2013 Jan;33(1):35-44.

Hodgkins P, Sasane R, Christensen L, Erder H, Harley C. Persistence, augmentation, and consumption of long-acting medications in ADHD patients. Am J Pharm Benefits. 2012 Dec;4(6):e149-e158.

Yeung AS, Jing Y, Brenneman SK, Chang TE, Baer L, Hebden T, Kalsekar I, McQuade RD, Kurlander J, Siebenaler J, Feva M. Clinical outcomes in measurement-based treatment (COMET): A trail of depression monitoring and feedback to primary care physicians. Depress Anxiety. 2012 Oct;29(10):865-73.

Burke JP, Sanchez R, Joshi AV, Cappelleri JC, Kulakodlu M, Halpern R. Health care costs in patients with painful diabetic peripheral neuropathy prescribed pregabalin or duloxetine. Pain Pract. 2012 Mar;12(3):209-18.

Chang TE, Jing Y, Yeung AS, Brenneman SK, Kalsekar I, Hebden T, McQuade R, Baer L, Kurlander JL, Watkins AK, Siebenaler JA, Fava M. Effect of communicating depression severity on physician prescribing patterns: Findings from the clinical outcomes in measurement-based treatment (COMET) trial. Gen Hosp Psychiatry. 2012 Mar-Apr;34(2):105-12.

Burke JP, Sanchez R, Joshi AV, Cappelleri JC, Kulakodlu M, Halpern R. Health care costs in patients with fibromyalgia on pregabalin vs. duloxetine. Pain Pract. 2012 Jan;12(1):14-22.

Halpern R, Agarwal S, Borton L, Oneacre K, Lopez-Bresnahan MV. Adherence and persistence among multiple sclerosis patients after one immunomodulatory therapy failure: Retrospective claims analysis. Adv Ther. 2011 Sep;28(9):761-75.

Lal LS, Hung F, DaCosta Byfield S, Miller LA, Feng C, Adamus A, Arbuckle R. Evaluation of medication compliance in patients on antidepressants at an outpatient tertiary cancer center setting. J Oncol Pharm Pract. 2011 Jun;17(2):131-35.

Halpern R, Agarwal S, Dembek C, Borton L, Lopez-Bresnahan M. Comparison of adherence and persistence among multiple sclerosis patients treated with disease modifying therapies: A retrospective administrative claims analysis. Patient Prefer Adherence. 2011 Jan;5:73-84.

Leider HL, Dhaliwal J, Davis EJ, Kulakodlu M, Buikema AR. Healthcare costs and nonadherence among chronic opioid users. Am J Manag Care. 2011 Jan;17(1):32-40.

Borah BJ, Sacco P, Zarotsky V. Predictors of adherence among Alzheimer’s disease patients receiving oral therapy. Curr Med Res Opin. 2010 Aug;26(8):1957-65.

Stensland MD, Schultz JF, Frytak JR. Depression diagnoses following the identification of bipolar disorder: Costly incongruent diagnoses. BMC Psychiatry. 2010 Jun 4;10:39.

Christensen L, Sasane R, Hodgkins P, Harley C, Tetali S. Pharmacological treatment patterns among patients with attention-deficit/hyperactivity disorder: Retrospective claims-based analysis of a managed care population. Curr Med Res Opin. 2010 Apr; 26(4):977-89.

Holt RJ, Sklar AR, Darkow T, Goldberg GA, Johnson JC, Harley CR. Prevalence of Parkinson’s disease-induced psychosis in a large US managed care population. J Neuropsychiatry Clin Neurosci. 2010 Winter; 22(1):105-10.

Baldessarini R, Henk H, Sklar A, Chang J, Leahy L. Psychotropic medications for patients with bipolar disorder in the United States: polytherapy and adherence. Psychiatr Serv. 2008 Oct;59(10):1175–83.

Frytak J, Henk HJ, Zhao Y, Bowman L, Flynn JA, Nelson M. Health service utilization among Alzheimer’s disease patients: Evidence from managed care. Alzheimers Dement. 2008 Sep;4(5):361-67.

Stensland MD, Schultz JF, Frytak JR. Diagnosis of unipolar depression following initial identification of bipolar disorder: A common and costly misdiagnosis. J Clin Psychiatry. 2008 May;69(5):749-58.

Krahn DD, Bohn MJ, Henk HJ, Grossman JL, Gosnell B. Patterns of urges during early abstinence in alcohol-dependent subjects. Am J Addict. 2005 May-Jun;14(3):248-55.

Braun L, Riedel AA, Cooper LM. Severe sepsis in managed care: Analysis of incidence, one-year mortality, and associated costs of care. J Manag Care Pharm. 2004 Nov-Dec;10(6):521-30.

Durkin M, Pesa J, Lopatto J, Halpern R, Korrer S, Van Voorhis D. Comparison of real-world outcomes between patients treated with tapentadol ER or oxycodone CR. JHEOR. 2015;2(2):221-32.

Chastek B, Oleen-Burkey M, Lopez-Bresnahan MV. Medical chart validation of an algorithm for identifying multiple sclerosis relapse in healthcare claims. J Med Econ. 2010;13(4):618-25.

Panish JM, Dirani R, Halpern R, Cao F. Exploratory analysis of psychiatric-related utilization and costs associated with paliperidone ER compared with other oral atypical antipsychotics using pharmacy claims from an administrative database. J Med Econ. 2010;13(4):610-17.

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