Active Choice in the EHR to Promote Statin Therapy
| Status: | Enrolling by invitation |
|---|---|
| Conditions: | Peripheral Vascular Disease |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/6/2018 |
| Start Date: | September 24, 2018 |
| End Date: | March 23, 2019 |
Using Active Choice in the EHR to Promote Cardiologists to Prescribe Evidence-Based Statin Therapy
Cardiovascular (CV) events are the leading cause of mortality in the United States. Statins
have been demonstrated to be an effective tool for reducing CV events and mortality, but
statins are often either not prescribed or under-prescribed for patients that meet
evidence-based guidelines. In this study, we will evaluate a health system initiative using
active and passive choice prompts in the electronic health record to prompt cardiologists to
prescribe evidence-based statin therapy. In partnership with the health system, this will be
conducted as a randomized, controlled trial to evaluate its effect.
have been demonstrated to be an effective tool for reducing CV events and mortality, but
statins are often either not prescribed or under-prescribed for patients that meet
evidence-based guidelines. In this study, we will evaluate a health system initiative using
active and passive choice prompts in the electronic health record to prompt cardiologists to
prescribe evidence-based statin therapy. In partnership with the health system, this will be
conducted as a randomized, controlled trial to evaluate its effect.
This study will use a randomized, controlled trial to evaluate a health system initiative.
Cardiologists randomly assigned to the control arm will receive no interventions. For
cardiologists randomly assigned to the active choice intervention, the electronic health
record will be used to prompt cardiologists to initiate or change statin therapy for patients
not on evidenced-based guidelines based on the 2013 American College of Cardiology / American
Heart Association (ACC/AHA) and the National Lipid Association (NLA) through a "best practice
alert" in Epic which appears on the screen and forces a decision before the clinician can
move on. For cardiologists randomly assigned to the passive choice intervention, the
electronic health record will be used to create a passive alert using the same evidence-based
guidelines. The passive alert will not block clinician workflow and instead will be available
in the background for the cardiologist to open and then use to make a prescribing decision.
The intervention period will be 6 months in duration.
Cardiologists randomly assigned to the control arm will receive no interventions. For
cardiologists randomly assigned to the active choice intervention, the electronic health
record will be used to prompt cardiologists to initiate or change statin therapy for patients
not on evidenced-based guidelines based on the 2013 American College of Cardiology / American
Heart Association (ACC/AHA) and the National Lipid Association (NLA) through a "best practice
alert" in Epic which appears on the screen and forces a decision before the clinician can
move on. For cardiologists randomly assigned to the passive choice intervention, the
electronic health record will be used to create a passive alert using the same evidence-based
guidelines. The passive alert will not block clinician workflow and instead will be available
in the background for the cardiologist to open and then use to make a prescribing decision.
The intervention period will be 6 months in duration.
Inclusion Criteria:
- Have a cardiologist at the University of Pennsylvania Health System
- Meets 2013 ACC/AHA or NLA guidelines for statin prescription
Exclusion Criteria:
- Allergy to statins
- Severe renal insufficiency defined as glomerular filtration rate (GFR) less than 30
mL/min or on dialysis
- Adverse reaction to statins including a) myopathy, b)rhabdomyolysis, c)hepatitis
- Pregnant
- On a PCSK9 Inhibitor medication
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