预测分析和临床决策支持以改善准备处方 (PrEDICT)
预测分析和临床决策支持,以改善社区卫生中心的准备处方
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.
研究概览
地位
地位
干预/治疗
干预/治疗
研究类型
研究类型
注册 (估计的)
注册
阶段
阶段
- 不适用
联系人和位置
学习地点
-
-
California
-
Fremont、California、美国、94538
- Bay Area Community Health Liberty Clinic
-
Oakland、California、美国、94605
- Lifelong East Oakland Health Center
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Oceanside、California、美国、92054
- TrueCare Oceanside Family Medicine
-
Palm Springs、California、美国、92262
- DAP Legacy
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Sacramento、California、美国、95811
- One Community Health Midtown Campus
-
-
Connecticut
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Bridgeport、Connecticut、美国、06605
- Southwest Community Health Center 968 Fairfield Avenue
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-
Georgia
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Atlanta、Georgia、美国、30312
- Mercy Care Decatur Street
-
-
Iowa
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Sioux City、Iowa、美国、51105
- Siouxland Community Health Center Sioux City
-
-
Massachusetts
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Lynn、Massachusetts、美国、01901
- Lynn Community Health Center 269 Union
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Mattapan、Massachusetts、美国、02126
- Mattapan Community Health Center Blue Hill
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-
Ohio
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Cleveland、Ohio、美国、44102
- Neighborhood Family Practice Ridge Community Health Center
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Painesville、Ohio、美国、44077
- Signature Health Painesville
-
-
Oklahoma
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Oklahoma City、Oklahoma、美国、73112
- Variety Care Sequoyah
-
-
Oregon
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Portland、Oregon、美国、97214
- Prism Belmont
-
-
Texas
-
Houston、Texas、美国、77031
- Bee Busy Wellness Center Bray Oaks
-
-
Washington
-
Seattle、Washington、美国、98122
- Seattle Roots Community Health Carolyn Downs Community Clinic
-
-
参与标准
资格标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
手臂数量
武器和干预
参与者组/臂参与者组/臂 |
干预/治疗干预/治疗 |
|---|---|
|
无干预: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 |
|
|
有源比较器: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. |
研究衡量的是什么?
主要结果指标
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
PrEP initation
大体时间: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
|
次要结果测量
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
PrEP persistence
大体时间:30 months
|
Proportion of patients prescribed PrEP who persist on PrEP for 6 and 12 months, as measured by prescription refills ordered. |
30 months
|
合作者和调查者
合作者
合作者
研究记录日期
研究主要日期
学习开始 (实际的)
学习开始
初级完成 (估计的)
初级完成
研究完成 (估计的)
研究完成
研究注册日期
首次提交
首次提交
首先提交符合 QC 标准的
首先提交符合 QC 标准的
首次发布 (实际的)
首次发布
研究记录更新
最后更新发布 (实际的)
最后更新发布
上次提交的符合 QC 标准的更新
上次提交的符合 QC 标准的更新
最后验证
最后验证
更多信息
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