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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control | No Intervention | No intervention | |
| Active choice | Experimental | 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. |
|
| Active choice with social comparison feedback | Experimental | 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 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Active choice | Behavioral | Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin |
|
| Measure | Description | Time Frame |
|---|---|---|
| Statin Prescribing Rate | Percentage of patients eligible for a statin that have been prescribed a statin | Two Months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mitesh Patel, MD, MBA, MS | University of Pennsylvania | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Pennsylvania Health System | Philadelphia | Pennsylvania | 19104 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30646039 | Derived | Patel MS, Kurtzman GW, Kannan S, Small DS, Morris A, Honeywell S Jr, Leri D, Rareshide CAL, Day SC, Mahoney KB, Volpp KG, Asch DA. Effect of an Automated Patient Dashboard Using Active Choice and Peer Comparison Performance Feedback to Physicians on Statin Prescribing: The PRESCRIBE Cluster Randomized Clinical Trial. JAMA Netw Open. 2018 Jul 6;1(3):e180818. doi: 10.1001/jamanetworkopen.2018.0818. |
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No informed consent was obtained from the participants in this study.
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| ID | Title | Description |
|---|---|---|
| FG000 | Control | No intervention |
| FG001 | Active Choice | 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. Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin |
| FG002 | Active Choice With Social Comparison Feedback | 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 Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin. Social comparison feedback: Statin prescribing rates are communicated to physicians and along with how their performance compares to their peers |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Control | No intervention |
| BG001 | Active Choice | 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. Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Statin Prescribing Rate | Percentage of patients eligible for a statin that have been prescribed a statin | Posted | Count of Participants | Participants | Two Months |
|
2 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Control | No intervention | 0 |
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Physicians and patients were from a single health care system and we did not have data on prescription fill rates.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Rebecca Pepe | University of Pennsylvania | 215-360-0951 | peper@pennmedicine.upenn.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 1, 2017 | Oct 30, 2018 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D002318 | Cardiovascular Diseases |
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| Social comparison feedback | Behavioral | Statin prescribing rates are communicated to physicians and along with how their performance compares to their peers |
|
| BG002 | Active Choice With Social Comparison Feedback | 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 Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin Social comparison feedback: Statin prescribing rates are communicated to physicians and along with how their performance compares to their peers |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
| Annual Household Income | Count of Participants | Participants |
|
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 Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin Social comparison feedback: Statin prescribing rates are communicated to physicians and along with how their performance compares to their peers |
|
|
| 1,566 |
| 0 |
| 1,566 |
| 0 |
| 1,566 |
| EG001 | Active Choice | 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. Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin | 0 | 1,743 | 0 | 1,743 | 0 | 1,743 |
| EG002 | Active Choice With Social Comparison Feedback | 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 Active choice: Statin options are framed to physicians as an active choice to prescribe or not prescribe a statin Social comparison feedback: Statin prescribing rates are communicated to physicians and along with how their performance compares to their peers | 0 | 1,465 | 0 | 1,465 | 0 | 1,465 |
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