Investigator Robert Romanelli, Ph.D., MPH

Robert Romanelli, Ph.D., MPH, is Associate Scientist at the Palo Alto Medical Foundation Research Institute (PAMFRI). His interests include comparative effectiveness research, medication compliance, and health disparities. Specifically, he is interested in understanding patterns in drug utilization and the effectiveness of medications in real-world clinical practice across diverse populations. He is also interested in methods to improve causal inferences in observational research.

Prior to joining PAMFRI, Robert worked as a clinical services researcher within Sutter Health’s Clinical Integration Department, where he performed research on medication utilization in various therapeutic areas and conducted evaluations of pharmacist-led interventions and programs designed to improve clinical outcomes within an ambulatory-care setting.

He received a Ph.D. in Biomedical Sciences from the Pennsylvania State University College of Medicine and postdoctoral training in pharmacology at the Oregon Health and Science University. He also holds an M.P.H. with a focus in epidemiology and outcomes research from the Johns Hopkins Bloomberg School of Public Health. Robert is an Adjunct Assistant Clinical Professor at the University of California San Francisco and a member of the International Society for Health Economics and Outcomes Research.

Palo Alto Medical Foundation Research Institute
795 El Camino Real
Ames Building
Palo Alto, CA, 94301-2302
(650) 330-5865
romanerj1@sutterhealth.org

Primary Research Interests

Research Studies

Does the Medicare Preventive Visit Coverage Benefit Seniors With Multiple Chronic Conditions?

We will assess the impact of covered preventive visits among Medicare beneficiaries using electronic health records data from PAMF, between 2006 and 2015.

Investigators: Sukyung Chung Ph.D., Assistant Scientist, Robert Romanelli Ph.D., MPH, Associate Scientist

Effect of Therapeutic Class on Generic Drug Substitutions

Evaluate and rank-order generic substitution rates by therapeutic class, as well as examine factors associated with higher/lower rates of generic substitution.

Investigators: External PI Principal Investigator, Robert Romanelli Ph.D., MPH, Associate Scientist

Evaluation of a Lifestyle Intervention Adopted for Clinical Practice for Diabetes Prevention (ELEVATE-DP)

This study will identify important barriers to and facilitators of translating an efficacious diabetes prevention intervention (Group Lifestyle Balance, GLB)

Investigators: Kristen M.J. Azar R.N., BSN, MSN/MPH, Investigator, Sukyung Chung Ph.D., Assistant Scientist, Robert Romanelli Ph.D., MPH, Associate Scientist

Medication Adherence and Patient Satisfaction With Provider Communication Difference Across Diverse Racial/Ethnic Groups

The goal of this study is to evaluate the role of patient satisfaction with experience of care and adherence to medications in diverse race/ethnic groups.

Investigators: Sukyung Chung Ph.D., Assistant Scientist, Robert Romanelli Ph.D., MPH, Associate Scientist

Prescription Amphetamine-based Stimulants and Pulmonary Hypertension

In retrospective, longitudinal cohort study, examine the relationship between use of prescription amphetamine-based stimulants and pulmonary hypertension.

Investigators: Robert Romanelli Ph.D., MPH, Associate Scientist, Sandra Wilson Ph.D., Senior Scientist

Redesigning Chronic Pain Management in Primary Care: Improving Coordination, Outcomes, and Experience

Evaluate the Chronic Pain Management Redesign Program that involves provider and patient education, and the development of electronic resources.

Investigators: Robert Romanelli Ph.D., MPH, Associate Scientist, Sandra Wilson Ph.D., Senior Scientist

Publications

Pharmacist-led medication management program within a patient-centered medical home.

The impact of a clinical pharmacist-led medication management program within a patient-centered medical home was evaluated.

Comparative effectiveness of early versus delayed metformin in the treatment of type 2 diabetes.

Treatment with metformin earlier in the course of type 2 diabetes is associated with better glycemic control, more pronounced weight reduction, and a lower risk for therapy intensification than delayed treatment. Antihyperglycemic therapy should be initiated early after diagnosis to achieve optimal outcomes.

A fully automated diabetes prevention program, Alive-PD: program design and randomized controlled trial protocol.

Randomized trial will provide rigorous evidence regarding the efficacy of this Internet-based program in preventing progression to diabetes.

Dabigatran versus warfarin for atrial fibrillation in real-world clinical practice: a systematic review and meta-analysis.

In real-world clinical practice, dabigatran is comparable with warfarin in preventing ischemic stroke among patients with nonvalvular atrial fibrillation. However, dabigatran is associated with a lower risk for intracranial bleeding relative to warfarin, but, particularly among the elderly, a greater risk for gastrointestinal bleeding. Bleeding outcomes from observational studies are consistent with those from the pivotal Randomized Evaluation of Long-Term Anticoagulation Therapy trial.

Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.

Given actual wait times, Asians perceive longer wait time and were less satisfied with wait times. Asians may have different expectations about wait time at the clinic.

Diabetes prevention and weight loss with a fully automated behavioral intervention by email, web, and mobile phone: a randomized controlled trial among persons with prediabetes.

Alive-PD improved glycemic control, body weight, BMI, waist circumference, TG/HDL ratio, and diabetes risk. As a fully automated system, the program has high potential for scalability and could potentially reach many of the 86 million US adults who have prediabetes as well as other at-risk groups.

Dyslipidemia in special ethnic populations.

Culturally-tailored prevention and intervention should be provided to the minority populations with elevated risk for dyslipidemia and considerably more research is needed to determine the best approaches to helping specific subgroups.

Forces influencing generic drug development in the United States: a narrative review.

Review of influences on, and strategies to incentivize, generic drug development in the U.S.

Estimating generic drug use with electronic health records data from a health care delivery system: implications for quality improvement and research.

Algorithm that estimates generic drug use performed well in managed care pop. Methods may be used for QI and research, esp. when pharm. claims aren't available.

Dyslipidemia in special ethnic populations.

Culturally-tailored prevention and intervention should be provided to the minority populations with elevated risk for dyslipidemia.

Predictors of statin compliance after switching from branded to generic agents among managed-care beneficiaries.

The majority of study patients switched from branded to generic agents were compliant with therapy in the first 6 months after switching.

Improving adherence to best-practice guidelines for venous thromboembolism risk assessment and prevention.

Use of a nurse case manager and developing an automated VTE-risk-assessment tool improved adherence to best practice guidelines.

Disparities in blood pressure control within a community-based provider network: an exploratory analysis.

Potential disparities, particularly among diabetic individuals and those of minority race/ethnicity, were found with regard to BP control and the agents used to treat hypertension.

Disparities in adherence to and persistence with antihypertensive regimens: an exploratory analysis from a community-based provider network.

Disparities were found with regard to adherence to and persistence with antihypertensive regimens.

Treatment and management of postmenopausal osteoporosis within an ambulatory care network.

Proportion of community pts with premenopausal osteoporosis who received pharmacologic treatment at diagnosis and had a baseline DXA scan was relatively low.

Multivariate analysis of factors associated with persistent colesevelam treatment among patients with hypercholesterolemia.

This study identified several patient demographic and characteristics associated with persistent colesevelam treatment that may help develop strategies to improve treatment persistence and optimize clinical outcomes.

Colesevelam in the treatment of hypercholesterolemia and hyperglycemia: a retrospective analysis from an ambulatory care medical network.

Colesevelam treatment in a real-world setting was associated with improvements in LDL-C and HBA1C through 24 months of follow-up.

Behavioral therapy and serotonin reuptake inhibitor pharmacotherapy in the treatment of obsessive compulsive disorder: a systematic review and meta-analysis of head-to-head randomized controlled trials.

We sought to review evidence from head-to-head randomized controlled trials (RCTs) of behavioral therapy and SRIs in the treatment of OCD.

Compliance after switching from branded to generic statins.

The purpose of this study was to evaluate the impact of switching from branded to generic statins on medication compliance. Compliance with statin therapy was largely similar among patients who switch to generic statins and those remaining on branded statins.

Increasing prevalence of primary biliary cholangitis and reduced mortality with treatment.

Prevalence of PBC increased from 2004-2014. Pt demographic and clinical characteristics, as well as ursodeoxycholic acid tx, affected mortality.

Factors associated with prevalence and treatment of primary biliary cholangitis in United States health systems.

Analyzed a large cohort of pts with PBC receiving routine clinical care. Observed significant differences in PBC prevalence and treatment by sex, race, and age.

Opioid prescribing for chronic pain in a community-based healthcare system.

Opioid prescribing to pts with chronic pain varied by type & number of pain conditions. Such Rx's to men, those with back pain, & Medicaid recipients were high.

A shared medical appointment on the benefits and risks of opioids is associated with improved patient confidence in managing chronic pain.

A shared medical appointment on the benefits and risks of opioids was associated with prompt improvements in patients’ confidence in self-managing pain.

Provider and patient determinants of generic levothyroxine prescribing: an electronic health records-based study.

Generic levothyroxine prescribing differed by PCPs and endocrinologists. Residual variation in generic prescribing, after accounting for measurable factors, indicates the need for provider interventions or patient education aimed at improving levothyroxine generic uptake.

Patient characteristics and healthcare utilization of a chronic pain population within an integrated healthcare system.

Based on prevalence, comorbidities, and healthcare utilization, several types of CP, including neuropathies/neuralgias, arthritis/joint pain, and unclassified pain, appear to be most impactful.

Patients' medication-related experience of care is associated with adherence to cardiometabolic disease therapy in real-world clinical practice.

Efforts to include pts in tx decision making and provide education on meds are solutions to improve adherence to CMD tx and outcomes.

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Investigator Robert Romanelli, Ph.D., MPH

Primary Research Interests

Research Studies

Publications

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