Statin Reminders for Improving Prescribing in Primary Care
- Conditions
- Clinical Decision SupportEducationCholesterol, Elevated
- Interventions
- Other: Interruptive ReminderOther: Non-interruptive ReminderOther: No Reminder
- Registration Number
- NCT06456658
- Lead Sponsor
- Vanderbilt University Medical Center
- Brief Summary
Statins reduce cardiovascular events and mortality, but only 30% of eligible primary care patients nationally are on statins. Clinical decision support (CDS) interventions in the electronic health record (EHR) can deliver education to providers and increase adherence to guideline recommendations via many potential forms of delivery. Interruptive alerts are an effective form of CDS but disrupt clinician workflow and increase alert fatigue in an age of clinician burnout and frustration with the EHR. Non-interruptive reminders are proposed as an alternative method of delivering CDS; however, they require active pursuit by the provider, and their effectiveness compared to interruptive alerts has not been rigorously studied. The investigators propose a randomized trial comparing the effect of interruptive vs. non-interruptive reminders displayed to clinicians to increase statin prescribing in primary care clinics.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 6000
- Patients between the ages of 18 and 75
- Seen in primary care visit within Vanderbilt University Medical Center
- Eligible for statin therapy due to 1) Atherosclerotic cardiovascular disease (ASCVD) 10- year risk greater than or equal to 10%, 2) Type 1 or 2 diabetes and aged 40 years or older, or 3) ASCVD diagnosis
- Already on statin, ezetimibe, bempedoic acid, or PCSK9 inhibitor
- Last low-density lipoprotein cholesterol (LDL-C) less than 100 mg/dL
- Pregnant or lactating
- Palliative care
- Statin allergy or adverse effect of statin
- Rhabdomyolysis
- Statin contraindicated due to liver disease, defined as 1) Decompensated liver disease, 2) AST or ALT greater than 5 times the upper limit of normal, or 3) Total bilirubin greater than 1.5 mg/dL
- Statin contraindicated due to kidney disease, defined as 1) Dialysis or 2) Estimated glomerular filtration rate less than 15 ml/min/1.73m^2
- Has had coronary calcium computerized tomography
- Less than 3 months since lipid panel resulted
- Acute visit
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Interruptive Reminder Group Interruptive Reminder Providers will receive education via a pop-up alert at the time that the chart is opened for eligible patient visits assigned to the interruptive reminder group. Non-Interruptive Reminder Group Non-interruptive Reminder Providers will be able to seek out education at their own initiative via an on-demand reminder within a section of the chart for eligible patient visits assigned to the non-interruptive reminder group. No Reminder Group No Reminder No alert recommending a statin will be displayed/available to the provider. The system will record eligibility through triggering a "silent" reminder, which is not displayed to the clinician and exists solely for data collection purposes.
- Primary Outcome Measures
Name Time Method Statin prescription within 24 hours Baseline to 24-hours Statin prescription within 24 hours post-enrollment (either interruptive, non-interruptive, or silent/hidden reminder).
- Secondary Outcome Measures
Name Time Method Low density lipoprotein-cholesterol (LDL-C) level Baseline to 12 months One LDL-C level within 12 months post-enrollment.
Statin prescription within 12 months Baseline to 12 months Statin prescription within 12 months post-enrollment.
Trial Locations
- Locations (1)
Vanderbilt University Medical Center
🇺🇸Nashville, Tennessee, United States