Cardiovascular disease is a major cause of morbidity and mortality among people living with HIV. Recent studies have demonstrated that patients with HIV experience a 50-100% increased risk of myocardial infarction and stroke compared to HIV-uninfected persons. They also face higher risks of stroke, sudden death, and heart failure. However, evidence-based statin therapy-which is safe in this population and highly effective at reducing cardiovascular risk-is under-prescribed. The investigators propose a multi-level intervention to increase evidence-based statin prescribing by addressing barriers at these levels. The implementation intervention includes two strategies: (1) tailored education at the leadership, provider, and patient levels, and (2) behavioral economics-informed feedback for providers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
75
Investigators will conduct semi-structured interviews with medical directors, clinical leadership and all participating physicians to gain insight on knowledge about and barriers to prescribing statins for people living with HIV. People living with HIV will participate in focus groups.
Education intervention will be adapted from the the findings of these interviews and focus groups. Clinics will be randomized to receive the "education intervention and feedback" implementation strategies at different times. Medical directors and providers will receive a brief educational intervention about cardiovascular disease risk in people living with HIV. Providers will additionally receive a web-based survey before and after the education intervention. Patients will receive pamphlets tailored to the effects of cardiovascular disease treatment for people living with HIV.
Six months after the education intervention, providers will receive monthly emails with feedback regarding their rates of prescribing statins, with language targeted at increasing motivation to prescribe by leveraging social norms and self-image.
JWCH Institute
Commerce, California, United States
Antelope Valley Health Center
Lancaster, California, United States
Watts Health Center
Los Angeles, California, United States
Oasis Clinic
Los Angeles, California, United States
To Help Everyone Health and Wellness Centers
Los Angeles, California, United States
Venice Family Clinic
Santa Monica, California, United States
Olive View-UCLA Medical Center
Sylmar, California, United States
Tarzana Treatment Centers, Inc.
Tarzana, California, United States
Change in proportion of PLWH with cardiovascular risk factors seen by a physician receiving statin therapy
Time frame: 12 months
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