Leah Zullig

Overview:

Leah L. Zullig, PhD, MPH is a health services researcher, Associate Professor in the Duke Department of Population Health Sciences, investigator at the Durham Veterans Affairs Medical Center, and Adjunct Assistant Professor of Health Policy and Management at the University of North Carolina at Chapel Hill. Her research is supported by a VA HSR&D Career Development Award, focused on improving colorectal cancer survivors’ care quality through a self-management intervention bridging cancer surveillance and chronic disease management. Dr. Zullig’s overarching research interests address the reduction of healthcare disparities, improving cancer care delivery and quality, and promoting cancer survivorship and chronic disease self-management. She has authored over 90 peer-reviewed publications.

Dr. Zullig completed her BS in Health Promotion, her MPH in Public Health Administration, and her PhD in Health Policy.

Areas of expertise: Implementation Science, Health Measurement, Health Policy, Health Behavior, and Health Services Research

Positions:

Associate Professor in Population Health Sciences

Population Health Sciences
School of Medicine

Associate Professor in Medicine

Medicine, General Internal Medicine
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

Ph.D. 2013

University of North Carolina at Chapel Hill

Fellow

Washington University in St. Louis

Grants:

Dissemination and Implementation Science in Cardiovascular Outcomes (DISCO)

Administered By
Basic Science Departments
Awarded By
National Institutes of Health
Role
Mentor
Start Date
End Date

Dissemination and Implementation Science in Cardiovascular Outcomes (DISCO)

Administered By
Basic Science Departments
Awarded By
National Institutes of Health
Role
Mentor
Start Date
End Date

A Clinic-Based Behavioral Intervention to Reduce Cardiovascular Disease Risk in Persons Living with HIV

Administered By
Medicine, Infectious Diseases
Awarded By
National Institutes of Health
Role
Advisor
Start Date
End Date

PhRMA Editorial

Administered By
Population Health Sciences
Role
Investigator
Start Date
End Date

PROCESS

Administered By
Population Health Sciences
Role
Principal Investigator
Start Date
End Date

Publications:

Embracing Implementation Science: A Paradigm Shift for Nursing Research.

Authors
Zullig, LL; Deschodt, M; De Geest, S
MLA Citation
Zullig, Leah L., et al. “Embracing Implementation Science: A Paradigm Shift for Nursing Research..” J Nurs Scholarsh, Dec. 2019. Pubmed, doi:10.1111/jnu.12507.
URI
https://scholars.duke.edu/individual/pub1423813
PMID
31811696
Source
pubmed
Published In
J Nurs Scholarsh
Published Date
DOI
10.1111/jnu.12507

Aging

MLA Citation
Zullig, L. L., et al. “Aging.” Handbook of Cancer Survivorship: Second Edition, 2018, pp. 91–109. Scopus, doi:10.1007/978-3-319-77432-9_6.
URI
https://scholars.duke.edu/individual/pub1421455
Source
scopus
Published Date
Start Page
91
End Page
109
DOI
10.1007/978-3-319-77432-9_6

Primary Care Providers' Acceptance of Pharmacists' Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease.

BACKGROUND: Patients with diabetic kidney disease (DKD) often struggle with blood pressure control. In team-based models of care, pharmacists and primary care providers (PCPs) play important roles in supporting patients' blood pressure management. OBJECTIVE: To describe whether PCPs' acceptance of pharmacists' recommendations impacts systolic blood pressure (SBP) at 36 months. DESIGN: An observational analysis of a subset of participants randomized to the intervention arm of the Simultaneous risk factor control using Telehealth to slOw Progression of Diabetic Kidney Disease (STOP-DKD) study. PARTICIPANTS: STOP-DKD participants for whom (1) the pharmacist made at least one recommendation to the PCP; (2) there were available data regarding the PCP's corresponding action; and (3) there were SBP measurements at baseline and 36 months. INTERVENTION: Participants received monthly telephone calls with a pharmacist addressing health behaviors and medication management. Pharmacists made medication-related recommendations to PCPs. MAIN MEASURES: We fit an unadjusted generalized linear mixed model to assess the association between the number of pharmacists' recommendations for DKD and blood pressure management and PCPs' acceptance of such recommendations. We used a linear regression model to evaluate the association between PCP acceptance and SBP at 36 months, adjusted for baseline SBP. KEY RESULTS: Pharmacists made 176 treatment recommendations (among 59 participants), of which 107 (61%) were accepted by PCPs. SBP significantly declined by an average of 10.5 mmHg (p < 0.01) among 47 of 59 participants who had valid measurements at baseline and 36 months. There was a significant association between the number of pharmacist recommendations and the odds of PCP acceptance (OR 1.19; 95%CI 1.00, 1.42; p < 0.05), but no association between the number of accepted recommendations and SBP. CONCLUSIONS: Pharmacists provided actionable medication-related recommendations. We identified a significant decline in SBP at 36 months, but this reduction was not associated with recommendation acceptance. TRIAL REGISTRATION: NCT01829256.
Authors
Zullig, LL; Jazowski, SA; Davenport, CA; Diamantidis, CJ; Oakes, MM; Patel, S; Moaddeb, J; Bosworth, HB
MLA Citation
Zullig, Leah L., et al. “Primary Care Providers' Acceptance of Pharmacists' Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease..” J Gen Intern Med, Oct. 2019. Pubmed, doi:10.1007/s11606-019-05403-x.
URI
https://scholars.duke.edu/individual/pub1417898
PMID
31659655
Source
pubmed
Published In
J Gen Intern Med
Published Date
DOI
10.1007/s11606-019-05403-x

Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa.

PURPOSE OF REVIEW: To review the current literature on use of telehealth at different stages of the hypertension control cascade in sub-Saharan Africa (SSA) and to discuss opportunities to harness technology infrastructure in SSA to improve population-level blood pressure control. RECENT FINDINGS: Despite the high burden of hypertension in SAA, strategies to improve awareness, diagnosis, and management are inadequate. In high-income countries, telehealth has increased patient access to high-quality care at reduced costs. Notwithstanding the limited evidence on the use of telehealth at the different stages of the hypertension control cascade in SSA, the few published interventions in this review reported reduction of blood pressure and increase in the proportion of individuals with controlled blood pressure. Telehealth use across the hypertension control cascade in SSA is promising. These under-resourced settings provide opportunity to better understand the demand for these interventions in order to achieve meaningful clinical outcomes.
Authors
Muiruri, C; Manavalan, P; Jazowski, SA; Knettel, BA; Vilme, H; Zullig, LL
MLA Citation
Muiruri, Charles, et al. “Opportunities to Leverage Telehealth Approaches Along the Hypertension Control Cascade in Sub-Saharan Africa..” Curr Hypertens Rep, vol. 21, no. 10, Aug. 2019. Pubmed, doi:10.1007/s11906-019-0983-2.
URI
https://scholars.duke.edu/individual/pub1406555
PMID
31451940
Source
pubmed
Published In
Curr Hypertens Rep
Volume
21
Published Date
Start Page
75
DOI
10.1007/s11906-019-0983-2

How are medication related problems managed in primary care? An exploratory study in patients with diabetes and primary care providers.

BACKGROUND: Medication self-management is important for patients who are controlling diabetes. Achieving medication self-management goals, may depend on treatment complexity and patients' capacities such as health literacy, knowledge and attitude. OBJECTIVES: The aims of this study were to explore how patients with diabetes self-manage their medications, how patients seek support when experiencing problems and how primary healthcare providers identify patients' medication related problems and provide support. METHODS: Semi-structured interviews were conducted among patients with diabetes receiving primary care and with their primary healthcare providers - GPs, nurses, pharmacists and technicians - between January and June 2017. A purposive sampling strategy was used to identify and select participants. An interview guide based on the Cycle of Complexity model was developed. Interviews were audiotaped and transcribed verbatim. Transcripts were coded with a combination of deductive and inductive codes. A thematic analysis was performed to identify categories and themes in the data. Findings were compared with the Cycle of Complexity model. RESULTS: Twelve patients and 27 healthcare providers were included in the study. From the transcripts 95 codes, 6 categories and 2 major themes were extracted. Patients used practical solutions and gaining knowledge to manage their medication. Their problems were often related to stress and concerns about using medications. A trusted relationship with the healthcare provider was essential for patients to share problems and ask for support. Informal support was sought from family and peer-patients. Healthcare providers perceive problem identification as challenging. They relied on patients coming forward, computer notifications, clinical parameters and gut-feeling. Healthcare providers were able to offer appropriate support if a medication management problem was known. CONCLUSION: Patients are confident of finding their way to manage their medications. However, sharing problems with healthcare providers requires a trusted relationship. This is acknowledged by both patients and healthcare providers.
Authors
van Eikenhorst, L; Taxis, K; Rademakers, J; Zullig, LL; de Gier, H; van Dijk, L
MLA Citation
van Eikenhorst, L., et al. “How are medication related problems managed in primary care? An exploratory study in patients with diabetes and primary care providers..” Res Social Adm Pharm, Aug. 2019. Pubmed, doi:10.1016/j.sapharm.2019.08.004.
URI
https://scholars.duke.edu/individual/pub1406640
PMID
31427177
Source
pubmed
Published In
Res Social Adm Pharm
Published Date
DOI
10.1016/j.sapharm.2019.08.004

Research Areas:

Attitude to Health
Behavior Therapy
Benchmarking
Cancer
Cardiovascular Diseases
Caregivers
Clergy
Communication
Delivery of Health Care
Delivery of Health Care, Integrated
Diabetes Complications
Diabetes Mellitus
Diabetes Mellitus, Type 2
Diffusion of Innovation
Disclosure
Disease Management
Drug Packaging
Evidence-Based Medicine
Feasibility Studies
Glycated Hemoglobin A
Guideline Adherence
Health Care Costs
Health Expenditures
Health Services Accessibility
Healthcare Disparities
Hemoglobin A, Glycosylated
Hypertension
Minority Health
Oncology
Osteoarthritis
Outcome and Process Assessment (Health Care)
Pastoral Care
Patient-Centered Care
Pilot Projects
Program Evaluation
Quality of Health Care
Quality of Life
Religion and Psychology
Reproducibility of Results
Self Care
Survivors
Telemedicine
Treatment Outcome
Veterans Health