Larry Lynd
About the Principal Investigator
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Training
| Degree: | B.Sc., Pharmacy |
| Institution: | University of Saskatchewan |
| Year: | 1986 |
| Degree: | Ph.D., Epidemiology |
| Institution: | University of British Columbia |
| Year: | 2002 |
Current Position
| Position: | Associate Professor; Associate Director of the Collaboration for Outcomes Research and Evaluation (CORE); MSFHR Scholar; CIHR New Investigator; Peter Wall Institute of Advanced Studies Early Career Scholar |
Links
Research Interests
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Research Focus
Since joining the University of British Columbia, Dr. Lynd has been the Associate Director of the Collaboration of Outcomes Research and Evaluation (CORE) – website: www.core.ubc.ca. The mission of CORE is to improve health-related outcomes to drug therapy through the application of the best in research, education, and practice enhancement strategies. This involves collaboration with other outcomes researchers, professional organizations, and policy makers. Our mandate has been to develop CORE in terms of both research and training in pharmaceutical outcomes. In this regard, over the past six years we have hired a core group of epidemiologists, health economists, and statisticians, have recruited and successfully trained many graduate students, and acquired the computer resources to undertake sophisticated modeling and analysis. We have also established collaborative associations with other key stakeholders including the BC College of Pharmacists, BC Pharmacy Association, BC Ministry of Health, and BC Pharmacare, and we collaborate both nationally and internationally. In addition to training graduate students in outcomes research, we have developed the first undergraduate course in pharmacoeconomics and health technology assessment with the objective of training clinicians in critical thinking, understanding health care and policy decision making, and incorporating evidence into clinical practice.
Current Projects
Cost-Effectiveness Analysis for Cognitive Behavioural Therapy for Depression.
The objectives of this analysis were to develop a decision analytic model to compare the treatment of the pharmacologic management of depression with cognitive behavioural therapy (CBT). We developed a decision analytic model comparing pharmacotherapy to CBT for the treatment of depression over a two year time horizon from both the perspective of the health care system and the societal perspective. All model parameters (costs, probabilities, and utilities) are extracted from the literature including previously published studies comparing pharmacotherapy to another alternative treatment strategy, CBT to another alternative treatment strategy, from head-to-head trials, or from previously published economic analyses. Results of our analysis show that over a two year period, CBT was cost-saving despite the higher cost of treatment itself. In terms of benefits, accounting for quality of life, CBT results in a positive gain compared with pharmacotherapy. As such, CBT provides positive health gain while saving money for our healthcare system. Extrapolating the results to the provincial population, even treating a fraction of patients suffering from depression with CBT could result in significant overall improvement in health in British Columbia.
Calculating Direct Health Care Costs Associate with Asthma in British Columbia, 2002-2007.
We performed a population-based cohort study to examine the direct health care resource utilization attributable to asthma from the payer’s perspective in British Columbia (BC) for the years 2002-2007 and to evaluate the impact of asthma control on asthma-related resource utilization. The main strength of this study is the use of several linked health administrative databases from the government of BC allowing the identification of all asthmatic patients in BC. Thus, we analysed the data from Population Data BC, a patient-level database of healthcare and health services data, population and demographic data, and occupational data from 1985 onwards on BC's 4.5 million residents with health insurance. In addition, for each subject, we had access to the PharmaNet database, which captures data on all prescription drug dispensations for the entire BC population. This study is part of the Platform for Outcomes Research and Translation in Asthma and allergy (PORTAL), funded by AllerGen NCE.
Evaluating Parental and Pediatric Preferences for Asthma Control in Children Using Best-Worst Scaling.
The goal of this choice experiment was to determine the preferences of parents of children with asthma, and of adolescents with asthma, for different attributes of asthma control. Using a best worst choice experiment, we aim to determine the relative importance of various attributes that affect optimal asthma control based on stated preferences of children or their parents. The pilot stage of this study has been completed in collaboration with Dr. Wendy Unger at The Hospital for Sick Children, Toronto; the main phase of study is currently in progress.
Economic Evaluation for the Detection/Screening for Pulmonary Hypertension in Systemic Sclerosis Patients.
Current projects include a systematic review of cost-effectiveness analyses for the diagnosis of pulmonary embolism. We are also working on a project relating to the early detection of pulmonary hypertension in systemic sclerosis (SSc) patients. The prevalence of pulmonary hypertension has been reported to be significant higher in this sub-population, and as such, finding a cost-effective diagnostic strategy to detect the presence of pulmonary hypertension can have marked effect on the outcomes of these patients.
The Prevention of Organ Failure (PROOF) Centre – Economic Evaluation of Biomarker Strategies.
The mission of the PROOF Centre of Excellence is “to discover, develop, commercialize and implement non-invasive biomarker tests for the prevention, prediction, diagnosis, management, and treatment of diseases associated with organ failure.” As such, economic evaluation is central to this mission in determining value for money for these testing strategies. These evaluations assist in the development and implementation phases of these strategies and provide evidence for reimbursement from third party payers. Currently, CORE is participating in economic evaluations of the following programs:
- Biomarkers in Transplantation program
- Chronic obstructive pulmonary disease
- Chronic heart failure
- Chronic kidney disease
The Feasibility of Using Community Pharmacists in Focused Surveillance for Drug Safety and Effectiveness: A Case Study of Anti-Hypertensives in Pregnancy.
The lack of consensus regarding non-severe hypertension thresholds and targets as well as the variability in antihypertensive therapy choices leaves the maternal and perinatal populations affected by hypertensive disorders of pregnancy, open to wide variability in care. This variability in care needs to be monitored and linked with perinatal outcomes. Community pharmacies provide an ideal setting to initiate a surveillance strategy to monitor antihypertensive prescription use for women during pregnancy and while breastfeeding. In this feasibility trial, community pharmacists are recruiting pregnant and breastfeeding women in their pharmacies and providing enhanced care including blood pressure measurement, adverse drug reaction reporting, monitoring appropriateness of antihypertensive prescriptions, and over-the-counter drug, natural medicine, and lifestyle choice advising. Pharmacists follow-up with their patients over 6 months and maternal drug histories will be linked with the BC Perinatal Database at the end of the study.
Selected Publications
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Within last 5 years:
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