For Ph.D. candidate Jerusha Daggolu, the path to healthcare began long before medical school, research questions or data analysis. It began in high school, when a growing interest in biology and human health collided with a deeply personal family experience.
Her grandmother became ill and deteriorated within months.
“At a young age, I did not know much about her disease or what she was going through, but I could see the helplessness of the whole family as we moved from hospital to hospital and treatment to treatment,” Daggolu said.
Daggolu said that experience left her with questions that would later shape her career: Why do treatments work for some patients and not for others? What determines whether patients survive, improve or struggle with complications? And how can healthcare providers better understand the full picture of a patient’s experience?
Daggolu went on to earn her M.D. in general surgery from Osmania Medical College in Hyderabad, India, where she received broad training in complex medical and surgical conditions. At first, she was committed to a career as a surgeon. Research was not part of the original plan.
But her clinical experience continued to raise questions.
“During my clinical training and practice, I saw many patients who were expected to respond to treatment in a certain way but did not respond as expected,” Daggolu said. “Those variations are often influenced by different factors, such as access and barriers to care, medication side effects and the cost of treatment,” Daggolu said.
Daggolu said these factors helped her decide to transition into research full-time.
Today, Daggolu’s work sits at the intersection of clinical medicine, health outcomes and real-world evidence. Her dissertation focuses on adolescents and young adults with serious mental disorders like schizophrenia, bipolar disorder and major depressive disorder, who are treated with second-generation antipsychotics — medications that are effective in controlling symptoms but can also cause significant metabolic side effects.
“There are many studies which have shown that antipsychotics are effective,” Daggolu said. “But the main side effect of these starts with weight gain, then leads to insulin resistance, diabetes and cardiovascular morbidity. All these factors may lead to patients not adhering to the treatment.”
Her research compares metformin and GLP-1 receptor agonists as potential strategies to address antipsychotic-induced weight gain and support antipsychotic adherence. Metformin is a well-established, lower-cost medication that may help control weight gain, while GLP-1 receptor agonists can lead to greater weight loss but often come with barriers.
“I am comparing these two treatments while considering factors such as cost, access to care, insurance and patient comorbidities to see which drug is better at counteracting antipsychotic-induced weight gain,” Daggolu said. “This is important in adolescents and young adults because of the long-term impact on both mental health and metabolic health.”
To answer these questions, Daggolu uses administrative claims data, which allows her to study how treatments are used outside the controlled environment of clinical trials. Her research examines treatment patterns, medication adherence and outcomes across large patient populations.
Daggolu found that younger patients were more likely to receive metformin, while older patients were more likely to receive GLP-1 receptor agonists. Insurance also appeared to play an important role, with Medicaid patients less likely to receive GLP-1 receptor agonists, potentially because of associated cost and coverage barriers.
Disease severity also mattered. Patients with more severe mental illness were more often prescribed metformin, which Daggolu said may reflect the challenges of adding an expensive injectable GLP-1 receptor agonist to an already complex treatment plan.
The ability to study these patterns is one reason Daggolu sees real-world data as a powerful tool.
“For me, improving care means bridging the gap between clinical trial evidence and real-world effectiveness,” Daggolu said. “When a medication is used outside of a controlled setting, is it giving similar results? Is the patient able to feel better, experience fewer side effects and tolerate the medication?”
The purpose of Daggolu’s research remains rooted in the same questions that first drew her to healthcare: how to better understand patients, how to improve care and how to make treatment work in the real world.
“It is about the long-term impact and whether the treatment truly works for the patient on a daily basis,” Daggolu said.