Jenny Ciganic

Interests

Research

Pharmacoepidemiology,Pharmaceutical health service research,Medication Adherence,Drug Safety,Cancer Prevention,Quality of Prescribing,Value of Prescribing,Diffusion of New Drugs for Management of Chronic Disease

Teaching

Biostatistics, Pharmacoepidemiology

Courses

Scholarly Contributions

Journals/Publications

• Almutairi, A. R., Zhou, L., Gellad, W. F., Lee, J. K., Slack, M. K., Martin, J. R., & Lo-Ciganic, W. H. (2017). Effectiveness and Safety of Non-vitamin K Antagonist Oral Anticoagulants for Atrial Fibrillation and Venous Thromboembolism: A Systematic Review and Meta-analyses. Clinical therapeutics, 39(7), 1456-1478.e36.
  More info

  The findings from the observational studies comparing the effectiveness and safety of non-vitamin K antagonist oral anticoagulants (NOACs) versus vitamin K antagonists (VKAs) for atrial fibrillation (AF) and venous thromboembolism (VTE) are inconsistent. We conducted separate meta-analyses examining the efficacy/effectiveness and safety of NOACs versus VKAs by disease (AF vs VTE), study design (randomized controlled trials [RCTs] vs observational studies), and NOAC (dabigatran, rivaroxaban, apixaban, and edoxaban).
• Anderson, T. S., Lo-Ciganic, W. H., Gellad, W. F., Zhang, R., Huskamp, H. A., Choudhry, N. K., Chang, C. H., Richards-Shubik, S., Guclu, H., Jones, B., & Donohue, J. M. (2017). Patterns and predictors of physician adoption of new cardiovascular drugs. Healthcare (Amsterdam, Netherlands).
  More info

  Little is known about physicians' approaches to adopting new cardiovascular drugs and how adoption varies between drugs of differing novelty.
• Cochran, G., Gordon, A. J., Gellad, W. F., Chang, C. H., Lo-Ciganic, W. H., Lobo, C., Cole, E., Frazier, W., Zheng, P., Kelley, D., & Donohue, J. M. (2017). Medicaid prior authorization and opioid medication abuse and overdose. The American journal of managed care, 23(5), e164-e171.
  More info

  The US opioid medication epidemic has resulted in serious health consequences for patients. Formulary management tools adopted by payers, specifically prior authorization (PA) policies, may lower the rates of opioid medication abuse and overdose. We compared rates of opioid abuse and overdose among enrollees in plans that varied in their use of PA from "High PA" (ie, required PA for 17 to 74 opioids), with "Low PA" (ie, required PA for 1 opioid), and "No PA" policies for opioid medications.
• Frazier, W., Cochran, G., Lo-Ciganic, W. H., Gellad, W. F., Gordon, A. J., Chang, C. H., & Donohue, J. M. (2017). Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid. JAMA, 318(8), 750-752.
• Hill, M. G., Gonzalez, M. G., Lo-Ciganic, W. H., & Reed, K. L. (2017). Misoprostol in Addition to a Double-Balloon Catheter for Induction: A Double-Blind Randomized Controlled Trial. American journal of perinatology.
• Lo-Ciganic, W. H., Floden, L., Lee, J. K., Ashbeck, E. L., Zhou, L., Chinthammit, C., Purdy, A. W., & Kwoh, C. K. (2017). Analgesic use and risk of recurrent falls in participants with or at risk of knee osteoarthritis: data from the Osteoarthritis Initiative. Osteoarthritis and cartilage.
  More info

  Few studies have compared the risk of recurrent falls across different types of analgesic use, and with limited adjustment for potential confounders (e.g., pain/depression severity). We assessed analgesic use and the subsequent risk of recurrent falls, among participants with or at risk of knee osteoarthritis (OA).
• Cochran, G., Gordon, A. J., Lo-Ciganic, W., Gellad, W. F., Frazier, W., Lobo, C., Chang, C. H., Zheng, P., & Donohue, J. M. (2016). An Examination of Claims-based Predictors of Overdose from a Large Medicaid Program. Medical care.
  More info

  Health systems may play an important role in identification of patients at-risk of opioid medication overdose. However, standard measures for identifying overdose risk in administrative data do not exist.
• Gordon, A., Lo-Ciganic, W., Cochran, G., Gellad, W. F., Cathers, T., & Donohue, J. M. (2016). Treatment Quality for Buprenorphine Care: The Pot at the End of the Rainbow. Journal of addiction medicine, 10(3), 210-1.
• Lo Ciganic, W. H., Jacob, M., Schlenk, E., Terhost, L., Bilt, J., Zgibor, J., Simkin-Silverman, L., Albert, S., & Newman, A. (2016). The Preventative Services Use Self-Efficacy (PRESS) Scale in Older Women; Development and Psychometric Properties. BMC Health Services Research.
• Lo-Ciganic, W., Boudreau, R. M., Gray, S. L., Zgibor, J. C., Donohue, J. M., Perera, S., Newman, A. B., Simonsick, E. M., Bauer, D. C., Satterfield, S., & Hanlon, J. T. (2013). Changes in cholesterol-lowering medications use over a decade in community-dwelling older adults. The Annals of pharmacotherapy, 47(7-8), 984-92.
  More info

  The impact of evidence-based guidelines and controlled trial data on use of cholesterol-lowering medications in older adults is unclear.
• Lo-Ciganic, W., Donohue, J. M., Jones, B. L., Perera, S., Thorpe, J. M., Thorpe, C. T., Marcum, Z. A., & Gellad, W. F. (2016). Trajectories of Diabetes Medication Adherence and Hospitalization Risk: A Retrospective Cohort Study in a Large State Medicaid Program. Journal of general internal medicine, 31(9), 1052-60.
  More info

  Numerous interventions are available to boost medication adherence, but the targeting of these interventions often relies on crude measures of poor adherence. Group-based trajectory models identify individuals with similar longitudinal prescription filling patterns. Identifying distinct adherence trajectories may be more useful for targeting interventions, although the association between adherence trajectories and clinical outcomes is unknown.
• Lo-Ciganic, W., Gellad, W. F., Huskamp, H. A., Choudhry, N. K., Chang, C. H., Zhang, R., Jones, B. L., Guclu, H., Richards-Shubik, S., & Donohue, J. M. (2016). Who Were the Early Adopters of Dabigatran?: An Application of Group-based Trajectory Models. Medical care, 54(7), 725-32.
  More info

  Variation in physician adoption of new medications is poorly understood. Traditional approaches (eg, measuring time to first prescription) may mask substantial heterogeneity in technology adoption.
• Zgibor, J. C., Schlenk, E. A., Vater, L., Kola, S., Vander Bilt, J., Woody, S., Jacob, M. E., Lo-Ciganic, W., Brenckle, A., Brandenstein, J., Kwoh, C. K., Boudreau, R., Albert, S., Conroy, M., Rodgers, E., & Newman, A. B. (2016). Partnership Building and Implementation of an Integrated Healthy-Aging Program. Progress in community health partnerships : research, education, and action, 10(1), 123-32.
  More info

  Evidence-based interventions exist for prevention of chronic disease in older adults. Partnering with community organizations may provide a mechanism for disseminating these interventions.
• Cochran, G., Woo, B., Lo-Ciganic, W., Gordon, A. J., Donohue, J. M., & Gellad, W. F. (2015). Defining Nonmedical Use of Prescription Opioids Within Health Care Claims: A Systematic Review. Substance abuse, 36(2), 192-202.
  More info

  Health insurance claims data may play an important role for health care systems and payers in monitoring the nonmedical use of prescription opioids (NMPO) among patients. However, these systems require valid methods for identifying NMPO if they are to target individuals for intervention. Limited efforts have been made to define NMPO using administrative data available to health systems and payers. We conducted a systematic review of publications that defined and measured NMPO within health insurance claims databases in order to describe definitions of NMPO and identify areas for improvement.
• Gordon, A. J., Lo-Ciganic, W., Cochran, G., Gellad, W. F., Cathers, T., Kelley, D., & Donohue, J. M. (2015). Patterns and Quality of Buprenorphine Opioid Agonist Treatment in a Large Medicaid Program. Journal of addiction medicine, 9(6), 470-7.
  More info

  Use of buprenorphine - an effective treatment for opioid use disorders (OUDs) - has increased rapidly in recent years and is often financed by Medicaid. We investigated predictors of buprenorphine treatment, patterns of care, and quality of care in a large state Medicaid program.
• Lo-Ciganic, W., Donohue, J. M., Thorpe, J. M., Perera, S., Thorpe, C. T., Marcum, Z. A., & Gellad, W. F. (2015). Using machine learning to examine medication adherence thresholds and risk of hospitalization. Medical care, 53(8), 720-8.
  More info

  Quality improvement efforts are frequently tied to patients achieving ≥80% medication adherence. However, there is little empirical evidence that this threshold optimally predicts important health outcomes.
• Lo-Ciganic, W., Gellad, W. F., Gordon, A. J., Cochran, G., Zemaitis, M. A., Cathers, T., Kelley, D., & Donohue, J. M. (2015). Associations between trajectories of buprenorphine treatment and emergency department and inpatient utilization. Addiction (Abingdon, England).
  More info

  Uncertainty about optimal treatment duration for buprenorphine opioid agonist therapy may lead to substantial variation in provider and payer decision-making regarding treatment course. We aimed to identify distinct trajectories of buprenorphine use and examine outcomes associated with these trajectories to guide health system interventions regarding treatment length.
• Lo-Ciganic, W., Perera, S., Gray, S. L., Boudreau, R. M., Zgibor, J. C., Strotmeyer, E. S., Donohue, J. M., Bunker, C. H., Newman, A. B., Simonsick, E. M., Bauer, D. C., Satterfield, S., Caserotti, P., Harris, T., Shorr, R. I., Hanlon, J. T., & , H. A. (2015). Statin use and decline in gait speed in community-dwelling older adults. Journal of the American Geriatrics Society, 63(1), 124-9.
  More info

  To examine the association between statin use and objectively assessed decline in gait speed in community-dwelling older adults.
• Minlikeeva, A. N., Freudenheim, J. L., Lo-Ciganic, W., Eng, K. H., Friel, G., Diergaarde, B., Modugno, F., Cannioto, R., Gower, E., Szender, J. B., Grzankowski, K., Odunsi, K., Ness, R. B., & Moysich, K. B. (2015). Use of common analgesics is not associated with ovarian cancer survival. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 24(8), 1291-4.
  More info

  Use of analgesics has been associated with lower risk of ovarian cancer, but, to date, very few studies have explored the association between analgesics and ovarian cancer survival.
• Schlenk, E. A., Bilt, J. V., Lo-Ciganic, W., Jacob, M. E., Woody, S. E., Conroy, M. B., Kwoh, C. K., Albert, S. M., Boudreau, R., Newman, A. B., & Zgibor, J. C. (2015). Pilot Enhancement of the Arthritis Foundation Exercise Program with a Healthy Aging Program. Research in gerontological nursing, 1-10.
  More info

  Older adults with arthritis or joint pain were targeted for a pilot program enhancing the Arthritis Foundation Exercise Program with the 10 Keys™ to Healthy Aging Program. Using a one-group, pre-post design, feasibility was examined and improvements in preventive behaviors, arthritis outcomes, and cardiometabolic outcomes were explored. A 10-week program was developed, instructors were recruited and trained, and four sites and 51 participants were recruited. Measures included attendance, adherence, satisfaction, preventive behaviors, Western Ontario and McMaster Universities Osteoarthritis Index (pain and stiffness), glucose, and cholesterol. Three fourths of participants attended >50% of the sessions. At 6 and 12 months, more than one half performed the exercises 1 to 2 days per week, whereas 28% and 14% exercised 3 to 7 days per week, respectively. Participants (92%) rated the program as excellent/very good. Nonsignificant changes were observed in expected directions. Effect sizes were small for arthritis and cardiometabolic outcomes. This program engaged community partners, demonstrated feasibility, and showed improvements in some preventive behaviors and health risk profiles. [Res Gerontol Nurs. 2015; x(x):xx-xx.].
• Trabert, B., Ness, R. B., Lo-Ciganic, W., Murphy, M. A., Goode, E. L., Poole, E. M., Brinton, L. A., Webb, P. M., Nagle, C. M., Jordan, S. J., , A. O., Risch, H. A., Rossing, M. A., Doherty, J. A., Goodman, M. T., Lurie, G., Kjær, S. K., Hogdall, E., Jensen, A., , Cramer, D. W., et al. (2014). Aspirin, nonaspirin nonsteroidal anti-inflammatory drug, and acetaminophen use and risk of invasive epithelial ovarian cancer: a pooled analysis in the Ovarian Cancer Association Consortium. Journal of the National Cancer Institute, 106(2), djt431.
  More info

  Regular aspirin use is associated with reduced risk of several malignancies. Epidemiologic studies analyzing aspirin, nonaspirin nonsteroidal anti-inflammatory drug (NSAID), and acetaminophen use and ovarian cancer risk have been inconclusive.
• Terry, K. L., Karageorgi, S., Shvetsov, Y. B., Merritt, M. A., Lurie, G., Thompson, P. J., Carney, M. E., Weber, R. P., Akushevich, L., Lo-Ciganic, W., Cushing-Haugen, K., Sieh, W., Moysich, K., Doherty, J. A., Nagle, C. M., Berchuck, A., Pearce, C. L., Pike, M., Ness, R. B., , Webb, P. M., et al. (2013). Genital powder use and risk of ovarian cancer: a pooled analysis of 8,525 cases and 9,859 controls. Cancer prevention research (Philadelphia, Pa.), 6(8), 811-21.
  More info

  Genital powder use has been associated with risk of epithelial ovarian cancer in some, but not all, epidemiologic investigations, possibly reflecting the carcinogenic effects of talc particles found in most of these products. Whether risk increases with number of genital powder applications and for all histologic types of ovarian cancer also remains uncertain. Therefore, we estimated the association between self-reported genital powder use and epithelial ovarian cancer risk in eight population-based case-control studies. Individual data from each study were collected and harmonized. Lifetime number of genital powder applications was estimated from duration and frequency of use. Pooled ORs were calculated using conditional logistic regression matched on study and age and adjusted for potential confounders. Subtype-specific risks were estimated according to tumor behavior and histology. 8,525 cases and 9,859 controls were included in the analyses. Genital powder use was associated with a modest increased risk of epithelial ovarian cancer [OR, 1.24; 95% confidence interval (CI), 1.15-1.33] relative to women who never used powder. Risk was elevated for invasive serous (OR, 1.20; 95% CI, 1.09-1.32), endometrioid (OR, 1.22; 95% CI, 1.04-1.43), and clear cell (OR, 1.24; 95% CI, 1.01-1.52) tumors, and for borderline serous tumors (OR, 1.46; 95% CI, 1.24-1.72). Among genital powder users, we observed no significant trend (P = 0.17) in risk with increasing number of lifetime applications (assessed in quartiles). We noted no increase in risk among women who only reported nongenital powder use. In summary, genital powder use is a modifiable exposure associated with small-to-moderate increases in risk of most histologic subtypes of epithelial ovarian cancer.
• Lo-Ciganic, W., Zgibor, J. C., Bunker, C. H., Moysich, K. B., Edwards, R. P., & Ness, R. B. (2012). Aspirin, nonaspirin nonsteroidal anti-inflammatory drugs, or acetaminophen and risk of ovarian cancer. Epidemiology (Cambridge, Mass.), 23(2), 311-9.
  More info

  Aspirin, nonaspirin nonsteroidal anti-inflammatory drugs (NA-NSAIDs) and acetaminophen all have biologic effects that might reduce the risk of ovarian cancer. However, epidemiologic data on this question are mixed.
• Lo-Ciganic, W., Zgibor, J. C., Ruppert, K., Arena, V. C., & Stone, R. A. (2011). Identifying type 1 and type 2 diabetic cases using administrative data: a tree-structured model. Journal of diabetes science and technology, 5(3), 486-93.
  More info

  To date, few administrative diabetes mellitus (DM) registries have distinguished type 1 diabetes mellitus (T1DM) from type 2 diabetes mellitus (T2DM).
• Lo Ciganic, W. H., Kao Yang, Y., & Sung, J. (2004). Antihypertensive agents and new-onset diabetes. ;. Kidney and Dialysis, 16, 225-240.
• Lo Ciganic, W. H., Li, Y., & Lin, C. (2004). Selective serotonin reuptake inhibitors (SSRI). National Cheng Kung University Pharmacy Forum (Chinese), 14, 6.

Poster Presentations

• Slack, M. K., Lo Ciganic, W. H., Almutari, A., Lili, Z., Lee, J. K., & Martin, J. R. (2016, Mary 2016). Comparative effectiveness and safety of dabigatran versus vitamin K antagonists in atrial fibrillation: A meta-analysis of observational studies. ISPOR. Washington, D.C.: ISPOR.