Proactive E-consults for COPD in HIV/AIDS Patients

(ACHIEVE Trial)

Recruiting at 7 trial locations

Overseen By John R Kundzins, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Seattle Institute for Biomedical and Clinical Research

Disqualifiers: Cognitive dysfunction, Language barriers, Psychiatric disorder

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

270 Participants Needed

Trial Summary

What is the purpose of this trial?

This study examines an intervention to promote effective, evidence-based care and de-implement inappropriate therapies for COPD in HIV-infected (HIV+) patients. The intervention facilitates specialist support of primary care, which includes infectious disease (ID) physicians who serve as the primary care providers (PCP) for their HIV+ patients in the ID clinic. Rather than relying on referral-driven specialty care which may be a barrier to access, pulmonologists will proactively support ID providers to manage a population of HIV+ patients with COPD, delivering real-time evidence-based recommendations tailored to the individual HIV+ patient in the form of an E-consult.

Research Team

Christian D. Helfrich, PhD, MPH

Principal Investigator

VA Puget Sound Health Care System

Kristina A Crothers, MD

Principal Investigator

VA Puget Sound Health Care System

David H Au, MD, MS

Principal Investigator

VA Puget Sound Health Care System

Eligibility Criteria

This trial is for HIV+ patients with Chronic Obstructive Pulmonary Disease (COPD) who are treated by outpatient infectious disease providers at one of the seven local sites in this study. It excludes those with significant cognitive dysfunction, language barriers, or severe psychiatric disorders that impair survey and interview participation.

Inclusion Criteria

Patients: HIV+ patients with COPD treated by providers enrolled in the study.

Providers: Outpatient infectious disease providers at one of the seven local sites participating in this study.

Exclusion Criteria

Providers: Trainees

I do not have severe mental health issues that would prevent me from understanding or participating in surveys and interviews.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Providers receive proactive E-consults with expert recommendations for COPD care prior to appointments with HIV+ patients with COPD

6 months

E-consults provided prior to patient appointments

Follow-up

Participants are monitored for satisfaction and quality of care after receiving E-consults

up to 3 years

Baseline and follow-up surveys and interviews

Treatment Details

Interventions

• Proactive E-consult

Trial Overview The study tests a proactive E-consult system where pulmonologists give real-time, tailored advice to infectious disease physicians managing HIV+ patients with COPD. This aims to improve care quality without relying on traditional referrals.

Participant Groups

Group I: Proactive E-consult Experimental Treatment 1 Intervention

Providers in this arm will receive proactive E-consults with expert recommendations for COPD care prior to appointments with HIV+ patients with COPD.

Group II: Usual care Active Control 1 Intervention

Providers in this arm will provide usual care to their HIV+ patients with COPD.

Who Is Running the Clinical Trial?

Seattle Institute for Biomedical and Clinical Research

Lead Sponsor

Trials

55

Recruited

13,700+

VA Tennessee Valley Health Care System

Collaborator

Trials

5

Recruited

1,400+

VA Puget Sound Health Care System

Collaborator

Trials

67

Recruited

225,000+

Washington D.C. Veterans Affairs Medical Center

Collaborator

Trials

45

Recruited

18,500+

VA Eastern Colorado Health Care System

Collaborator

Trials

55

Recruited

26,200+

Yale University

Collaborator

Trials

1,963

Recruited

3,046,000+

Corporal Michael J. Crescenz VA Medical Center

Collaborator

Trials

31

Recruited

9,900+

VA Connecticut Healthcare System

Collaborator

Trials

86

Recruited

8,800+

Nashville VA Medical Center

Collaborator

Trials

4

Recruited

770+

VA Greater Los Angeles Healthcare System

Collaborator

Trials

53

Recruited

8,700+