INcreasing Statin Prescribing in HIV Behavioral Economics REsearch

Summary

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.

Conditions

• HIV
• Cardiovascular Diseases

Interventions

BEHAVIORAL

Knowledge assessment

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.

BEHAVIORAL

Education Intervention

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.

BEHAVIORAL

Provider Feedback

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.

Sponsors & Collaborators

• RAND

  collaborator OTHER

• Olive View-UCLA Education & Research Institute

  collaborator OTHER

• University of California, Los Angeles

  lead OTHER

Principal Investigators

• Allison Diamant, MD, MSHS · University of California, Los Angeles

• William Cunningham, MD, MPH · University of California, Los Angeles

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

CROSSOVER

Eligibility

Min Age

40 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2019-03-04

Primary Completion

2023-12-31

Completion

2024-03-31

Countries

• United States

Study Locations