Pragmatic, Randomized Evaluation of Statin Active Choice to Reach Improved Outcomes Based on Evidence (PRESCRIBE)

University of Pennsylvania

Status: Completed

Conditions: Cardiovascular Diseases

Treatments: Behavioral: Active choice; Behavioral: Social comparison feedback

Study type: Interventional

Funder types: Other

Identifiers

NCT03021759

826125

Details and patient eligibility

About

In this study, the investigators will conduct a pragmatic, cluster-randomized, controlled trial to evaluate an active choice intervention with and without social comparison feedback to increase physician statin prescribing rates for eligible patients.

Full description

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. Strong evidence indicates that statin medications can reduce the risk of CVD and for those with CVD statins have been shown to reduce mortality. Despite this evidence, statins are under-prescribed. In this study, the investigators will test the effectiveness of nudges targeted to physicians using active choice and social comparisons feedback to increasing the rate at which statin medications are prescribed to patients eligible based on national practice guidelines.

Enrollment: 4,774 patients

Sex: All

Ages: 40 to 75 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Patient has a primary care physician at University of Pennsylvania Health System
• Patient meets 2013 AHA/ACC guidelines for statin therapy but no record of a statin prescription in the electronic health record

Exclusion criteria

• Patient has an allergy or adverse reaction to statins documented in the electronic health record
• Patient has glomerular filtration rate less than 30 mL/min
• Physicians (and their respective patients) will be excluded if they have less than 10 patients among their entire panel that are eligible for a statin

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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4,774 participants in 3 patient groups

Control

No Intervention group

Description:

No intervention

Active choice

Experimental group

Description:

Physicians will be asked to review a list of their patients eligible for statin therapy who are not yet prescribed a statin and make an active choice whether or not to prescribe a statin.

Treatment:

Behavioral: Active choice

Active choice with social comparison feedback

Experimental group

Description:

Physicians will be asked to review a list of their patients eligible for statin therapy who are not yet prescribed a statin and make an active choice whether or not to prescribe a statin. Physicians will receive social comparison feedback informing them of how their performance compares to their peers

Treatment:

Behavioral: Active choice

Behavioral: Social comparison feedback