Best Practice Advisory to Initiate High-Intensity Statin Therapy in Patients With Peripheral Artery Disease

Vanderbilt University Medical Center152 enrolled

Overview

The purpose of this study is to understand how a Best Practice Advisory (BPA) for high-intensity statin therapy in patients with Peripheral Artery Disease impacts prescription rates.

The central hypothesis is that an automated best practice advisory embedded within the electronic medical record (EMR) will improve prescription of high-intensity statins among hospitalized patients with Peripheral Artery Disease (PAD). Aim 1: To assess the impact of an automated best practice advisory, deployed as part of the standard hospital discharge workflow within the electronic medical record, on high-intensity statin prescription among hospitalized patients with PAD. Aim 2: To assess the impact of an automated best practice advisory, deployed as part of the standard hospital discharge workflow within the electronic medical record, on short-term cardiovascular outcomes among hospitalized patients with PAD.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

NONE

Enrollment

152

Conditions

Peripheral Artery Disease

Interventions

Best Practice AdvisoryOTHER

Patients in this arm will have a Best Practice Advisory displayed in the Electronic Medical Record (EMR) as part of the discharge order workflow.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Primary hospital diagnosis of PAD defined by ICD/CPT codes * Inpatient status at the adult hospital at Vanderbilt University Medical Center * Not currently prescribed a high-intensity statin (atorvastatin 40-80mg daily or rosuvastatin 20-40mg daily) Exclusion Criteria: * On comfort measures * History of statin allergy or intolerance recorded in the EMR * History of rhabdomyolysis defined by International Classification of Diseases/Current Procedural Terminology (ICD/CPT) codes * History of hepatitis A, B, or C defined by ICD/CPT codes * Pregnant * Aspartate aminotransferase \>120 units/L within 30 days of alert * Alanine aminotransferase \>165 units/L within 30 days of alert * Primary hospital diagnosis of acute myocardial infarction defined by ICD/CPT codes * Primary hospital diagnosis of acute stroke defined by ICD/CPT codes

Locations (1)

Vanderbilt University Medical Center

Nashville, Tennessee, United States

Outcomes

Primary Outcomes

Frequency of High-Intensity Statin Prescription at discharge

Frequency will be measured by identifying the number of high-intensity statin prescriptions at discharge

Time frame: Baseline, upon patient discharge through study completion, average of six months

Frequency of High-Intensity Statin Prescription at 90 days post-discharge

Frequency will be measured by identifying the number of high-intensity statin prescriptions at 90 days post-discharge.

Time frame: 90 days post-discharge

Secondary Outcomes

Frequency of a Composite of Cardiovascular Events

Frequency will be measured by identifying the number of cardiovascular events including myocardial infarction, coronary revascularization, stroke, lower extremity arterial revascularization, or all-cause mortality.

Time frame: Baseline, upon patient discharge to 90 days post-discharge through study completion

Data from ClinicalTrials.gov

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