Adjunct Faculty
Adjunct faculty typically have an academic or research appointment at another institution and contribute or collaborate with one or more School of Medicine faculty members or programs.
Adjunct rank detailsTiffany Chang
Assistant Professor AdjunctAbout
Research
Publications
2022
Rural Residence and Antihypertensive Medication Use in US Stroke Survivors
Tran PM, Tran LT, Zhu C, Chang T, Powers IP, Goldstein LB, Lichtman JH. Rural Residence and Antihypertensive Medication Use in US Stroke Survivors. Journal Of The American Heart Association 2022, 11: e026678. PMID: 35862140, PMCID: PMC9375512, DOI: 10.1161/jaha.122.026678.Peer-Reviewed Original ResearchConceptsUS stroke survivorsAntihypertensive medication useAntihypertensive useStroke survivorsLifestyle characteristicsMedication useBehavioral Risk Factor Surveillance System surveyUrban residenceSurvey-weighted logistic regressionRural stroke survivorsSurvey-weighted prevalenceHigh smoking prevalenceRecurrent strokeHypertension prevalenceSmoking prevalenceRural residentsRural residenceHypertensionReported historyLogistic regressionSurvivorsGeographic disparitiesSystem surveyPrevalenceSignificant increaseCardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study
Chang TE, Goldstein LB, Leifheit EC, Howard VJ, Lichtman JH. Cardiovascular Risk Factor Profiles, Emergency Department Visits, and Hospitalizations for Women and Men with a History of Stroke or Transient Ischemic Attack: A Cross-Sectional Study. Journal Of Women's Health 2022, 31: 834-841. PMID: 35148481, DOI: 10.1089/jwh.2021.0471.Peer-Reviewed Original ResearchConceptsStroke/transient ischemic attackTransient ischemic attackPrior stroke/transient ischemic attackCause ED visitsEmergency department visitsHealth care utilizationCross-sectional studyCause hospitalizationED visitsIschemic attackDepartment visitsCare utilizationCVD-RFsCardiovascular risk factor profileCardiovascular disease risk factorsCovariate-adjusted logistic regression modelsCause emergency department visitsHigher health care utilizationMedical Expenditure Panel Survey dataRisk factor profileDisease risk factorsHistory of strokeOdds of hospitalizationRepresentative Medical Expenditure Panel Survey dataSex-specific predictors
2020
Comparison of 3 Devices for 24-Hour Ambulatory Blood Pressure Monitoring in a Nonclinical Environment Through a Randomized Trial
Nwankwo T, King S, Ostchega Y, Zhang G, Loustalot F, Gillespie C, Chang TE, Begley EB, George MG, Shimbo D, Schwartz JE, Muntner P, Kronish IM, Hong Y, Merritt R. Comparison of 3 Devices for 24-Hour Ambulatory Blood Pressure Monitoring in a Nonclinical Environment Through a Randomized Trial. American Journal Of Hypertension 2020, 33: 1021-1029. PMID: 32701144, PMCID: PMC7641984, DOI: 10.1093/ajh/hpaa117.Peer-Reviewed Original ResearchConceptsAmbulatory blood pressure monitoringBlood pressure monitoringBP readingsABPM deviceSystolic BPPressure monitoringU.S. Preventive Services Task ForceAsleep systolic BPAwake systolic BPDiagnosis of hypertensionSleep quality questionnaireSystolic BP readingsBlood pressure readingsPart of screeningMobil-O-GraphPopulation-based surveyABPM readingsABPM testingDiastolic BPSleep disturbancesPressure readingsSleep differencesConvenience sampleSleep experiencesQuality questionnaireAssociation Between Cost-Related Medication Nonadherence and Hypertension Management Among US Adults
Fang J, Chang T, Wang G, Loustalot F. Association Between Cost-Related Medication Nonadherence and Hypertension Management Among US Adults. American Journal Of Hypertension 2020, 33: 879-886. PMID: 32369108, DOI: 10.1093/ajh/hpaa072.Peer-Reviewed Original ResearchConceptsCurrent antihypertensive medication useCost-related medication nonadherenceAntihypertensive medication useNormal blood pressureSelf-reported hypertensionBlood pressureMedication useHypertension managementMedication nonadherenceUS adultsPrevalence ratiosSelf-reported antihypertensive medication useNational Health Interview SurveyAdjusted prevalence ratiosHealth Interview SurveyAdherence persistUncontrolled hypertensionAdjusted prevalenceHypertensionAdjusted percentageNonadherenceInterview SurveyMonthsFinancial barriersAdultsTracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative.
Ritchey MD, Maresh S, McNeely J, Shaffer T, Jackson SL, Keteyian SJ, Brawner CA, Whooley MA, Chang T, Stolp H, Schieb L, Wright J. Tracking Cardiac Rehabilitation Participation and Completion Among Medicare Beneficiaries to Inform the Efforts of a National Initiative. Circulation. Cardiovascular Quality And Outcomes 2020, 13: e005902. PMID: 31931615, DOI: 10.1161/CIRCOUTCOMES.119.005902.Peer-Reviewed Original Research
2019
National Rates of Nonadherence to Antihypertensive Medications Among Insured Adults With Hypertension, 2015
Chang TE, Ritchey MD, Park S, Chang A, Odom EC, Durthaler J, Jackson SL, Loustalot F. National Rates of Nonadherence to Antihypertensive Medications Among Insured Adults With Hypertension, 2015. Hypertension 2019, 74: 1324-1332. PMID: 31679429, DOI: 10.1161/hypertensionaha.119.13616.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overAntihypertensive AgentsCross-Sectional StudiesFemaleHumansHypertensionIncidenceInsurance Claim ReviewInsurance CoverageMaleMedicaidMedicare Part DMedication AdherenceMiddle AgedRetrospective StudiesRisk AssessmentSensitivity and SpecificitySex FactorsUnited StatesConceptsBlood pressure controlMedication nonadherence ratesAntihypertensive medicationsNonadherence ratesHypertensive adultsUS adultsHealth insurancePressure controlNational ratesAvailable evidence-based interventionsAntihypertensive medication regimenAntihypertensive medication therapyEstimates of nonadherenceInsurance plan typePrescription claims dataIBM MarketScan databasesProportion of daysMultiple administrative datasetsEvidence-based interventionsMedicare Part DMedication regimenMedication therapyMarketScan databaseGreater nonadherencePrivate health insuranceAssociation between long-term adherence to class-I recommended medications and risk for potentially preventable heart failure hospitalizations among younger adults
Chang TE, Park S, Yang Q, Loustalot F, Butler J, Ritchey MD. Association between long-term adherence to class-I recommended medications and risk for potentially preventable heart failure hospitalizations among younger adults. PLOS ONE 2019, 14: e0222868. PMID: 31545830, PMCID: PMC6756532, DOI: 10.1371/journal.pone.0222868.Peer-Reviewed Original ResearchConceptsHeart failureMedication categoriesHF hospitalizationIsosorbide dinitrateGood adherenceEnzyme inhibitors/angiotensin receptor blockersIBM MarketScan Commercial DatabaseAngiotensin receptor blockersHeart failure hospitalizationReduced ejection fractionAldosterone receptor antagonistsMarketScan Commercial DatabaseLong-term adherencePoor health outcomesEffectiveness of interventionsLong-term managementGood adherersHF medicationsHospitalization 3Failure hospitalizationInsured adultsBeta blockersEjection fractionInitial diagnosisOutpatient settingTrends and Factors Associated With Concordance Between International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification Codes and Stroke Clinical Diagnoses
Chang TE, Tong X, George MG, King S, Yin X, O’Brien S, Ibrahim G, Liskay A, team T, Wiltz JL. Trends and Factors Associated With Concordance Between International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification Codes and Stroke Clinical Diagnoses. Stroke 2019, 50: 1959-1967. PMID: 31208302, DOI: 10.1161/strokeaha.118.024092.Peer-Reviewed Original ResearchConceptsClinical Modification codesIschemic strokeClinical diagnosisTenth RevisionDiagnosis categoryICD-CM codesTransient ischemic attackDisease surveillanceICD-9-CMIschemic attackPatient characteristicsIntracerebral hemorrhageStroke patientsSubarachnoid hemorrhagePatient dischargeHospital characteristicsICD-10-CMCare studiesHigher oddsInternational ClassificationPatient recordsHospitalLarge hospitalsSmall hospitalsCalendar quarter
2018
A Decade of Improvement in Door-to-Needle Time Among Acute Ischemic Stroke Patients, 2008 to 2017
Tong X, Wiltz JL, George MG, Odom EC, King S, Chang T, Yin X, team P, Merritt RK. A Decade of Improvement in Door-to-Needle Time Among Acute Ischemic Stroke Patients, 2008 to 2017. Circulation Cardiovascular Quality And Outcomes 2018, 11: e004981. PMID: 30557047, PMCID: PMC6329285, DOI: 10.1161/circoutcomes.118.004981.Peer-Reviewed Original ResearchMeSH KeywordsAdministration, IntravenousAdolescentAdultAgedAged, 80 and overBrain IschemiaFemaleFibrinolytic AgentsHealthcare DisparitiesHumansMaleMiddle AgedQuality ImprovementQuality Indicators, Health CareRegistriesRisk AssessmentRisk FactorsStrokeThrombolytic TherapyTime FactorsTime-to-TreatmentTissue Plasminogen ActivatorTreatment OutcomeUnited StatesYoung AdultConceptsPaul Coverdell National Acute Stroke ProgramAcute ischemic stroke patientsAcute Stroke ProgramDTN timeIschemic stroke patientsStroke ProgramNeedle timeStroke patientsAcute ischemic stroke admissionsAcute ischemic strokeIschemic stroke admissionsEmergency medical servicesIntravenous alteplaseSevere strokeStroke admissionsIschemic strokeBlack patientsOutside hospitalClinical benefitMedical historyOdds ratioAlteplasePatientsStrokeMedical servicesUse of Outpatient Rehabilitation Among Adult Stroke Survivors — 20 States and the District of Columbia, 2013, and Four States, 2015
Ayala C, Fang J, Luncheon C, King SC, Chang T, Ritchey M, Loustalot F. Use of Outpatient Rehabilitation Among Adult Stroke Survivors — 20 States and the District of Columbia, 2013, and Four States, 2015. MMWR Morbidity And Mortality Weekly Report 2018, 67: 575-578. PMID: 29795076, PMCID: PMC6433337, DOI: 10.15585/mmwr.mm6720a2.Peer-Reviewed Original ResearchConceptsStroke survivorsBehavioral Risk Factor Surveillance System dataEvidence-based guidelinesDistrict of ColumbiaAdult stroke survivorsSurveillance System dataQuality of lifeSystem-level interventionsPublic health communityStroke recurrenceHospital dischargeOutpatient rehabilitationFunctional outcomeOutpatient settingLeading causeStroke rehabilitationNational guidelinesBRFSS dataHealth systemStrokeHispanic originSurvivorsHealth communityAmerican adultsLevel of education