Best Practice Advisory to Initiate High-Intensity Statin Therapy in Patients With Peripheral Artery Disease
- Conditions
- Peripheral Artery Disease
- Interventions
- Other: Best Practice Advisory
- Registration Number
- NCT05166187
- Lead Sponsor
- Vanderbilt University Medical Center
- Brief Summary
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.
- Detailed Description
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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 152
- 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)
- 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
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Intervention Best Practice Advisory Patients randomized to the intervention arm will have a Best Practice Advisory (BPA) displayed as part of the discharge order workflow. This BPA requires clinicians to choose an option before completing the discharge documentation. Options include ordering one of the appropriate statins or documenting that the medication is contraindicated, the patient declined, or the patient does not meet criteria for a high-intensity statin.
- Primary Outcome Measures
Name Time Method Frequency of High-Intensity Statin Prescription at 90 days post-discharge 90 days post-discharge Frequency will be measured by identifying the number of high-intensity statin prescriptions at 90 days post-discharge.
Frequency of High-Intensity Statin Prescription at discharge Baseline, upon patient discharge through study completion, average of six months Frequency will be measured by identifying the number of high-intensity statin prescriptions at discharge
- Secondary Outcome Measures
Name Time Method Frequency of a Composite of Cardiovascular Events Baseline, upon patient discharge to 90 days post-discharge through study completion 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.
Trial Locations
- Locations (1)
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States