Predictive Analytics and Clinical Decision Support to Improve PrEP Prescribing (PrEDICT)
Predictive Analytics and Clinical Decision Support to Improve PrEP Prescribing in Community Health Centers
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.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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California
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Fremont, California, United States, 94538
- Bay Area Community Health Liberty Clinic
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Oakland, California, United States, 94605
- Lifelong East Oakland Health Center
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Oceanside, California, United States, 92054
- TrueCare Oceanside Family Medicine
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Palm Springs, California, United States, 92262
- DAP Legacy
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Sacramento, California, United States, 95811
- One Community Health Midtown Campus
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Connecticut
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Bridgeport, Connecticut, United States, 06605
- Southwest Community Health Center 968 Fairfield Avenue
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Georgia
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Atlanta, Georgia, United States, 30312
- Mercy Care Decatur Street
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Iowa
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Sioux City, Iowa, United States, 51105
- Siouxland Community Health Center Sioux City
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Massachusetts
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Lynn, Massachusetts, United States, 01901
- Lynn Community Health Center 269 Union
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Mattapan, Massachusetts, United States, 02126
- Mattapan Community Health Center Blue Hill
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Ohio
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Cleveland, Ohio, United States, 44102
- Neighborhood Family Practice Ridge Community Health Center
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Painesville, Ohio, United States, 44077
- Signature Health Painesville
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73112
- Variety Care Sequoyah
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Oregon
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Portland, Oregon, United States, 97214
- Prism Belmont
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Texas
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Houston, Texas, United States, 77031
- Bee Busy Wellness Center Bray Oaks
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Washington
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Seattle, Washington, United States, 98122
- Seattle Roots Community Health Carolyn Downs Community Clinic
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 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
Exclusion Criteria:
- Delivery site specializing in HIV or STI care
- Correctional facilities
- Mobile sites
- School-based health center sites
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
No Intervention: 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 |
|
|
Active Comparator: 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 |
The intervention will include automated EHR notifications to clinicians at 16 OCHIN community health centers about patients who are likely to benefit from PrEP. These patients will be identified by an HIV prediction model that was developed and validated during the pilot phase of this study using historical OCHIN EHR data. For patients above a preselected threshold of predicted HIV risk, clinicians will be notified at the point of care that the patient may benefit from PrEP and will be provided with EHR-based tools to support discussions and prescribing. The intervention will also include coaching on PrEP and the decision support tool, as well as project team support during the trial period. |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
PrEP initation
Time Frame: 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. |
30 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
PrEP persistence
Time Frame: 30 months
|
Proportion of patients prescribed PrEP who persist on PrEP for 6 and 12 months, as measured by prescription refills ordered. |
30 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- PH001008
- R01MH133515 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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