Predictive Analytics and Clinical Decision Support to Improve PrEP Prescribing in Community Health Centers
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 入组人数
- 16
- 试验地点
- 16
- 主要终点
- PrEP initation
研究概览
简要总结
Scale-up of HIV preexposure prophylaxis (PrEP) is a key strategy of the U.S. initiative to end the HIV epidemic, but healthcare providers lack tools to support PrEP discussions and prescribing for patients likely to benefit. This research will evaluate whether integrating automated tools into electronic health records to help providers efficiently and equitably identify potential candidates for PrEP, discuss PrEP, and prescribe PrEP can improve PrEP initiation and persistence in safety-net community health centers. It will achieve this by conducting a stepped-wedge trial of a decision support tool with an embedded HIV prediction model to identify patients likely to benefit from PrEP. The intervention will be delivered to healthcare providers in 16 community health centers within the national OCHIN network.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Delivery site saw at least 500 distinct patients in 2024 during in-person or telehealth visits
- •Delivery site had at least 10 new HIV diagnoses or positive HIV screening tests in 2023
- •Delivery site provides primary care other than pediatrics, and the primary care department(s) were active on OCHIN Epic as of 1/1/2023
排除标准
- •Delivery site specializing in HIV or STI care
- •Correctional facilities
- •Mobile sites
- •School-based health center sites
研究组 & 干预措施
Standard of Care
Data will be extracted from EHRs of control clinics as a comparison, and those clinics will not actively participate in study activities
Predictive analytics and clinical decision support
Providers in enrolled intervention clinics will receive point-of-care notifications via the EHR-embedded decision support tool about patients who are at increased predicted HIV risk and therefore likely to benefit from PrEP
干预措施: Predictive Analytics and Clinical Decision Support (Other)
结局指标
主要结局
PrEP initation
时间窗: 30 months
Proportion of patients above the prediction model risk threshold without a recently active PrEP prescription (within the prior 6 months) or prior HIV diagnosis who are prescribed PrEP during the study period.
次要结局
- PrEP persistence(30 months)
研究者
Julia Marcus
Associate Professor
Harvard Pilgrim Health Care