INcreasing Statin Prescribing in HIV Behavioral Economics REsearch

Behavioral Economics and Implementation Research to Reduce Cardiovascular Risk in HIV-Infected Adults

Cardiovascular disease is a major cause of morbidity and mortality among people living with HIV. Recent studies have demonstrated that patients with HIV experience a 50-100% increased risk of myocardial infarction and stroke compared to HIV-uninfected persons. They also face higher risks of stroke, sudden death, and heart failure. However, evidence-based statin therapy-which is safe in this population and highly effective at reducing cardiovascular risk-is under-prescribed. The investigators propose a multi-level intervention to increase evidence-based statin prescribing by addressing barriers at these levels. The implementation intervention includes two strategies: (1) tailored education at the leadership, provider, and patient levels, and (2) behavioral economics-informed feedback for providers.

Inclusion Criteria:

• age ≥ 40 years
• have been diagnosed with HIV
• LDL ≥ 190, diabetes and LDL ≥ 70
• or 10-year ASCVD risk ≥ 7.5%
• or history of heart attack, stroke, or peripheral vascular disease
• care for patients with HIV at least 1/2 day each week (physicians)
• work at participating clinics (physicians)

Exclusion Criteria:

• unable to provide written, informed consent
• not at participating clinic