학술논문

Reducing cardiovascular risk among people living with HIV: Rationale and design of the INcreasing Statin Prescribing in HIV Behavioral Economics REsearch (INSPIRE) randomized controlled trial
Document Type
article
Source
Progress in Cardiovascular Diseases. 63(2)
Subject
Biomedical and Clinical Sciences
Cardiovascular Medicine and Haematology
Prevention
Dissemination and Implementation Research
Heart Disease
Sexually Transmitted Infections
Behavioral and Social Science
Health Services
Comparative Effectiveness Research
HIV/AIDS
Clinical Research
Cardiovascular
Social Determinants of Health
Clinical Trials and Supportive Activities
Infectious Diseases
Infection
Good Health and Well Being
Anti-HIV Agents
Attitude of Health Personnel
Cardiovascular Diseases
Drug Prescriptions
Economics
Behavioral
Education
Medical
Continuing
HIV Infections
HIV Long-Term Survivors
Health Knowledge
Attitudes
Practice
Health Status
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Implementation Science
Inservice Training
Los Angeles
Medication Adherence
Multicenter Studies as Topic
Patient Education as Topic
Practice Patterns
Physicians'
Preventive Health Services
Protective Factors
Randomized Controlled Trials as Topic
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Viral Load
Cardiovascular disease
HIV
Statins
Behavioral economics
Implementation science
Cardiorespiratory Medicine and Haematology
Cardiovascular System & Hematology
Cardiovascular medicine and haematology
Language
Abstract
Cardiovascular disease (CVD) is a major cause of morbidity among people living with HIV (PLWH). Statins can safely and effectively reduce CVD risk in PLWH, but evidence-based statin therapy is under-prescribed in PLWH. Developed using an implementation science framework, INcreasing Statin Prescribing in HIV Behavioral Economics REsearch (INSPIRE) is a stepped-wedge cluster randomized trial that addresses organization-, clinician- and patient-level barriers to statin uptake in Los Angeles community health clinics serving racially and ethnically diverse PLWH. After assessing knowledge about statins and barriers to clinician prescribing and patient uptake, we will design, implement and measure the effectiveness of (1) educational interventions targeting leadership, clinicians, and patients, followed by (2) behavioral economics-informed clinician feedback on statin uptake. In addition, we will assess implementation outcomes, including changes in clinician acceptability of statin prescribing for PLWH, clinician acceptability of the education and feedback interventions, and cost of implementation.