Notify 2: An Evaluation of the Impact of Notification of Incidental Coronary Artery Calcium on Statin Rates

Stanford University

Overview

The primary objective is to estimate the impact of notification of primary care provider and patient of at least moderate incidental coronary artery calcification (CAC) on a prior non-gated chest CT on statin prescription rates at 4 months among patients without a clinical history of atherosclerotic cardiovascular disease not actively on statin therapy. This study will determine if notifying patients and their primary care clinician about an existing finding will influence shared decision-making around statins between patients and their primary care clinician.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Conditions

Coronary Artery Disease

Interventions

NotificationOTHER

Notification of patient and primary care clinician of presence of at least moderate coronary artery calcium on a prior non-gated chest CT

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Age greater than or equal to 18 and less than 85 2. Non-gated chest CT from 1/1/2016-6/30/2020 with algorithm screening estimating CAC score of at least 100 Agatston Units with radiologist confirmation of moderate or severe CAC 3. Encounter with Palo Alto VA affiliated primary care since 2020 Exclusion Criteria: 1. Prior diagnosis of coronary artery disease, peripheral artery disease, or cerebrovascular disease 2. Dementia 3. Metastatic cancer or active cancer undergoing chemotherapy 4. CT coronary angiogram since 2016 5. Invasive Coronary angiogram since 2016 6. CAC scan since 2016 7. Statin therapy within prior 6 months 8. Prior ezetimibe or PCSK9 inhibitor therapy 9. Prior rhabdomyolysis with statin therapy 10. Schizophrenia 11. Substance abuse disorder (alcohol, amphetamines, cocaine, opioids) 12. Hospice 13. Pregnancy

Locations (1)

Palo Alto Veteran's Affairs Hospital

Palo Alto, California, United States

Outcomes

Primary Outcomes

Statin prescription rate

Prescription of statin medication

Time frame: 4 months

Data from ClinicalTrials.gov

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