Optimizing Medications and Lung Health in People With HIV Through Pharmacist-led Proactive E-Consults
What You Need to Know Before You Apply
What is the purpose of this trial?
People with HIV (PWH) continue to experience elevated risk of community-acquired pneumonia despite effective antiretroviral therapy. Pneumonia contributes to hospitalization, respiratory failure, cardiovascular complications, long-term decline in lung function, and mortality. Several modifiable factors increase this risk, including active smoking, inadequate receipt of respiratory vaccinations, and inappropriate or prolonged use of inhaled corticosteroids (ICS) or proton-pump inhibitors (PPIs).
OPTIMIZE Lung-HIV is a multicenter, patient-level randomized controlled hybrid Type 1 effectiveness-implementation trial evaluating whether a proactive, pharmacist-led E-consult intervention can improve evidence-based pulmonary pharmacotherapy for PWH. Pharmacists will review electronic health records, generate tailored recommendations, and pre-enter orders related to smoking cessation pharmacotherapy, vaccinations, and deprescribing of ICS or PPIs. Providers may enact or modify recommendations as clinically appropriate.
The trial will assess the proportion of recommendations enacted within 3 months (primary outcome) and at 12 months (maintenance) and will use mixed methods guided by CFIR and RE-AIM to evaluate adoption, feasibility, acceptability, and implementation barriers and facilitators.
Who Is on the Research Team?
Kristina A. Crothers, MD
Principal Investigator
VA Puget Sound Health Care System
Ken M Kunisaki, MD,MS
Principal Investigator
Boise VA Medical Center
Orly Vardeny, PharmD
Principal Investigator
Minneapolis Veterans Affairs Medical Center
Are You a Good Fit for This Trial?
Inclusion Criteria
What Are the Treatments Tested in This Trial?
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
HIV+ patients randomized into in this arm will have proactive E-consults with pharmacist recommendations sent to enrolled providers prior to appointments
HIV+ Patients in this arm will receive usual care from their provider
Find a Clinic Near You
Who Is Running the Clinical Trial?
Seattle Institute for Biomedical and Clinical Research
Lead Sponsor
VA Puget Sound Health Care System
Collaborator
Minneapolis Veterans Affairs Medical Center
Collaborator
West Haven VA Medical Center
Collaborator
Boise VA Medical Center
Collaborator
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