About

Christopher R. Friese is a professor at the University of Michigan School of Nursing, holding the Elizabeth Tone Hosmer Professorship of Nursing. He is also a Professor in the Department of Systems, Populations and Leadership and serves as Associate Director for Cancer Control and Population Sciences at the University of Michigan Rogel Cancer Center. Dr. Friese is a national authority in measuring and improving the quality of cancer care delivery, with a focus on developing and testing strategies to improve outcomes of high-risk care. His research has established significant relationships between nurse practice environments and surgical mortality, and his findings have informed clinical practice guidelines and health policy at state and federal levels. He has authored over 150 peer-reviewed publications and has contributed to clinical guidelines and policy development. Dr. Friese's expertise includes the nursing care of patients with hematological malignancies and advanced cancers. He has served as a Robert Wood Johnson Foundation Health Policy Fellow in the U.S. Senate and was appointed in 2021 to a six-year term on the National Cancer Advisory Board, which sets national cancer research policy. His research interests encompass cancer health services research, quality and safety, nursing work environments, and health policy.

Research topics

• Internal medicine
• Medicine

Selected publications

• Patient symptoms, confidence, and adherence during the first 8 weeks of targeted oral anticancer agent treatment

  Supportive Care in Cancer · 2026-02-13

  articleOpen access

  PURPOSE: We aimed to understand patients' initial experiences with targeted oral anticancer agents (OAAs). We investigated symptoms experienced and how symptom severity affected patient confidence to manage and seek care for symptoms and OAA adherence. METHODS: We conducted a longitudinal prospective cohort study of patients during the first 8 weeks of targeted OAA treatment at an NCI-designated cancer center. Participants completed patient-reported outcome measures (PROMs) online at three timepoints. Descriptive statistics quantified demographics, cancer characteristics, symptom severity, confidence, and OAA adherence. Logistic regression was used to estimate confidence and adherence by each symptom at each timepoint. Mixed effects logistic regressions accounted for repeated measures and time effects on outcomes. RESULTS: Participants (n = 59) reported severe symptoms at all timepoints. Tiredness and drowsiness were most frequently reported as severe. Participants' confidence increased from timepoint 1 to 3. Most participants reported high confidence (61-86%) and excellent adherence (75-80%) across all timepoints, but 20-25% had less than excellent OAA adherence. High confidence to manage symptoms was positively associated with older age. Confidence to manage symptoms was inversely related to the severity of depression, tiredness, drowsiness, constipation, and tingling/numbness. CONCLUSION: Confidence to manage symptoms increased with time on OAAs, but severe symptoms persisted. Although self-reported OAA adherence was high, a notable number of participants reported suboptimal adherence. Relationships between confidence, symptom severity, and adherence should be identified in clinical settings to evaluate patients who may need extra clinical support during OAA treatment.

  PublisherOA PDFDOI

• The Impact of the COVID-19 Pandemic on Registered Nurse Employment Across Settings

  Medical Care · 2026-02-04

  articleCorresponding

  BACKGROUND: It is unknown whether the stress of the COVID-19 pandemic, which had a particular impact on inpatient and long-term care (LTC) nurses, had an effect on nurses' choice of employment settings. OBJECTIVE: Determine whether the COVID-19 pandemic contributed to changes in nurses' choice of employment setting. METHODS: This study used data from the 2018 and 2022 National Sample Survey of Registered Nurses to conduct a difference-in-difference analysis. We constructed a state-level measure of COVID-19 caseload, defined as COVID-19 cases per hospital bed; High versus Low COVID-19 states were defined as those above versus below the median, respectively. Logistic regression models were used to estimate the effect of exposure to High COVID-19 caseload (vs. Low) and time (2022 vs. 2018) on nurse employment choices across inpatient, LTC, outpatient, and nonclinical settings. RESULTS: From 2018 to 2022, the size of the US nursing workforce grew from 3.27 to 3.57 million nurses; however, RN FTEs increased in outpatient settings and decreased in all other settings. In adjusted analyses, nurses were less likely to work in LTC settings in 2022 than in 2018; yet, those exposed to High COVID-19 caseloads were 0.9% (95% CI: 0.3-1.5) more likely to work in LTC than those exposed to Low COVID-19 caseloads. Differences between High versus Low COVID-19 caseload exposure were not statistically significant for the likelihood of working in inpatient, outpatient, and nonclinical settings. CONCLUSIONS: Our findings suggest that exposure to High COVID-19 caseload was not associated with changes in nurses' employment settings.

  PublisherDOI

• Nonpharmacologic interventions for managing distress, anxiety, and depression for patients with cancer and their family caregivers: A systematic review and meta‐analysis

  CA A Cancer Journal for Clinicians · 2026-03-01

  articleOpen access

  As more cancer treatments take place in outpatient settings, family caregivers provide essential care and emotional support over long periods. Unaddressed patient and caregiver psychological distress can lead to worse outcomes, reflecting the challenges of managing complex care demands in the home setting. This systematic review and meta-analysis examined how well nonpharmacologic interventions (NPIs) reduce distress, anxiety, and depression in adult patients with solid tumors and their family caregivers. The authors included 68 randomized controlled trials (RCTs) with a total of 11,987 participants. NPIs were characterized as psychoeducation, therapeutic counseling, skills training, or behavior modification. By using random-effects models (Hedges g), they observed that NPIs significantly reduced patient distress at both 0.0-3.0 months (g = 0.13) and 3.1-6.0 months (g = 0.18), but NPIs did not significantly reduce caregiver distress. In the short term (0.0-3.0 months), NPIs also significantly reduced anxiety (g = 0.31 for patients; g = 0.15 for caregivers) and depression (g = 0.28 for patients; g = 0.25 for caregivers). Subgroup analyses examined the impact of patient and caregiver characteristics along with NPI type, delivery format, dose, and duration. NPIs delivered jointly to patients and caregivers yielded significant effects that were higher compared with NPIs delivered separately. NPIs can help manage distress in patients and reduce anxiety and depression in both patients and caregivers. However, the lack of long-term follow-up limits our understanding of their impact on patients and caregivers with prolonged or delayed psychological symptoms (PROSPERO registration number CRD42024536629).

  PublisherDOI

• Nurses carry substantial student loans: health care workforce implications

  Health Affairs Scholar · 2026-01-21

  articleOpen access1st authorCorresponding
  PublisherDOI

• Supplementary Table S2 from COVID-19 Outcomes by Cancer Status, Site, Treatment, and Vaccination

  2025-11-26

  articleOpen access

  <p>Codes used to define cancers diagnoses and treatments. Cancer sites are highlighted different colors and correspond to the highlighted rows of the same color in Table S1.</p>

  PublisherOA PDFDOI

• Supplementary Figure S1 from COVID-19 Outcomes by Cancer Status, Site, Treatment, and Vaccination

  2025-11-26

  articleOpen access

  <p>Flowchart describing derivation of COVID-19 tested analytic cohort from raw COVID-19 tested data.</p>

  PublisherOA PDFDOI

• Supplementary Table S4 from COVID-19 Outcomes by Cancer Status, Site, Treatment, and Vaccination

  2025-11-26

  articleOpen access

  <p>Logistic regression odds ratios (95% CI) for COVID-19 outcomes by chemotherapy treatment (without hematologic malignancy patients).</p>

  PublisherOA PDFDOI

• Supplementary Table S3 from COVID-19 Outcomes by Cancer Status, Site, Treatment, and Vaccination

  2025-11-26

  articleOpen access

  <p>Phecodes corresponding to the comorbidity classes included in the comorbidity score and their counts in the analytic tested-positive cohort.</p>

  PublisherOA PDFDOI

• Supplementary Figure S4 from COVID-19 Outcomes by Cancer Status, Site, Treatment, and Vaccination

  2025-11-26

  articleOpen access

  <p>An UpSet diagram showing the distribution of cancer treatment patterns among COVID-19 positive individuals with cancer (n = 13,752). Treatment-based analyses were performed using three mutually exclusive categories: chemotherapy (n = 2,910), radiation only (n = 690), and surgery only (n = 172). Treatment was defined according to Table S2.</p>

  PublisherOA PDFDOI

• Patients recently treated for B-lymphoid malignancies show increased risk of severe COVID-19: a CCC19 registry analysisImpact of B-cell malignancy therapy on COVID-19 outcomes

  UNC Libraries · 2025-04-18

  articleOpen access

  Patients with B-lymphoid malignancies have been consistently identified as a population at high risk of severe COVID-19. Whether this is exclusively due to cancer-related deficits in humoral and cellular immunity, or whether risk of severe COVID-19 is increased by anticancer therapy, is uncertain. Using data derived from the COVID-19 and Cancer Consortium (CCC19), we show that patients treated for B-lymphoid malignancies have an increased risk of severe COVID-19 compared with control populations of patients with non-B-lymphoid malignancies. Among patients with B-lymphoid malignancies, those who received anticancer therapy within 12 months of COVID-19 diagnosis experienced increased COVID-19 severity compared with patients with non-recently treated B-lymphoid malignancies, after adjustment for cancer status and several other prognostic factors. Our findings suggest that patients recently treated for a B-lymphoid malignancy are at uniquely high risk for severe COVID-19. SIGNIFICANCE: Our study suggests that recent therapy for a B-lymphoid malignancy is an independent risk factor for COVID-19 severity. These findings provide rationale to develop mitigation strategies targeted at the uniquely high-risk population of patients with recently treated B-lymphoid malignancies.

  PublisherDOI

Recent grants

• NIH Grant K99NR010750

  NIH · $178k · 2010

• NIH Grant R01HS024914

  NIH · $1.4M · 2020

• Randomized Controlled Trial to Improve Oncology Nurses' Protective Equipment Use

  NIH · $2.3M · 2014–2018

• Design and Methodology Core

  NIH · $26.7M · 2018

Frequent coauthors

• Celeste Leigh Pearce

  University of Michigan–Ann Arbor

  78 shared

• Lars G. Fritsche

  78 shared

• Alison M. Mondul

  78 shared

• Maxwell Salvatore

  77 shared

• Bhramar Mukherjee

  University of Michigan–Ann Arbor

  77 shared

• Sarah T. Hawley

  Michigan Medicine

  73 shared

• Miriam M. Hu

  71 shared

• Lauren J. Beesley

  University of Michigan–Ann Arbor

  71 shared

Labs

• University of Michigan School of NursingPI

Education

• Post Doctoral Fellowship, Department of Social and Behavioral Sciences

  Harvard School of Public Health

  2008

• Post Doctoral Fellow, Center for Outcomes and Policy Research

  Dana Farber Cancer Institute

  2008

• PhD, School of Nursing

  University of Pennsylvania

  2005

• BSN, School of Nursing

  University of Pennsylvania

  1997

Awards & honors

• International Nurse Researcher Hall of Fame, Sigma Theta Tau…
• Distinguished Researcher Award, Oncology Nursing Society (20…
• Elected Member, National Academy of Medicine (2020)
• Research Mentorship Award, AcademyHealth Interdisciplinary R…
• Elizabeth Tone Hosmer Endowed Professorship (inaugural holde…