课题基金 / 基金详情

Predictive Analytics and Clinical Decision Support to Improve PrEP Prescribing in Community Health Centers (PrEDICT)

Predictive Analytics and Clinical Decision Support to Improve PrEP Prescribing in Community Health Centers (PrEDICT)
预测分析和临床决策支持,以改善社区健康中心的 PrEP 处方 (PrEDICT)
批准号:
10699074
负责人:
Douglas Scott Krakower
金额:
$80.79万
依托单位国家:
美国
项目类别:
财政年份:
2023
资助国家:
美国
项目状态:
未结题
起止时间:
2023-09-06 至 2028-07-31

项目摘要

项目成果

Douglas Scott Krakower的其他基金

相似基金

相关文献

中文摘要
翻译
项目总结
英文摘要
PROJECT SUMMARY Rates of new HIV infections are disproportionately high, and uptake of preexposure prophylaxis (PrEP) low, in Black, Latino/a/x, and uninsured individuals in the US. Healthcare providers in community health centers (CHCs) could play a critical role in increasing PrEP prescribing to racial and ethnic minorities and other underserved populations. However, providers face barriers to PrEP prescribing, such as difficulty identifying candidates for PrEP; discomfort discussing sexual behavior; implicit biases about sexuality, race, and substance use; and lack of familiarity with PrEP care. We have found that providers are enthusiastic about the potential benefits of decision support tools to mitigate these barriers to PrEP provision, and that patients would find such tools acceptable if implemented sensitively. We previously showed that data from electronic health records (EHRs) can be used to identify patients at increased risk of HIV acquisition in two large, general practice healthcare systems. In our formative R34 research, we expanded on this approach in a safety-net setting, incorporating strategies to support not only identification of PrEP candidates but also PrEP discussions and prescribing. In a national network of CHCs serving 6.2 million patients in 46 states (OCHIN), we used machine learning with EHR data to identify patients at increased risk for incident HIV diagnosis (area under the curve 0.84). Using stakeholder-engaged qualitative methods, we then built an EHR-based decision support tool that uses our prediction model to prompt PrEP discussions with patients likely to benefit. The tool features a suite of resources to support initial PrEP prescribing, including suggested language for patient-centered discussions; information about PrEP indications, formulations, and dosing; laboratory order sets; diagnosis codes; and automated clinical notes. We piloted this tool at 3 CHCs, establishing feasibility and acceptability. We now propose Predictive Analytics and Clinical Decision Support to Improve PrEP Prescribing in Community Health Centers (PrEDICT) to evaluate the impact of our tool on PrEP provision in OCHIN CHCs. Our specific aims are to 1) expand and refine the decision support tool to facilitate PrEP follow-up care, and therefore patients’ persistence on PrEP; 2) quantify the impact of the decision support tool on PrEP initiation and persistence in a pragmatic stepped-wedge trial across 16 CHCs; and 3) identify patient populations with whom providers are less inclined to discuss PrEP when prompted to do so, and explore facilitators and barriers to equitable selection of patients for PrEP discussions. We will engage a diverse advisory group of patients from OCHIN CHCs in tool expansion, refinement, and implementation. This project is innovative in its use of predictive analytics and decision support to improve PrEP provision in safety-net settings. The research is significant because it has the potential to facilitate large increases in PrEP utilization using highly scalable tools. Our intervention addresses NIH priorities, aligns with the federal Ending the HIV Epidemic initiative, and could become a best practice for how CHCs and other healthcare systems support PrEP care delivery.
期刊论文(0)
专著(0)
科研奖励(0)
会议论文
Hybrid implementation-effectiveness study to optimize HIV testing and PrEP in a southern jail (HOTSPOT)
  • 批准号:
    10402603
  • 项目类别:
  • 资助金额:
    $63.91万
  • 财政年份:
    2022
  • 负责人:
    Douglas Scott Krakower
  • 依托单位:
Hybrid implementation-effectiveness study to optimize HIV testing and PrEP in a southern jail (HOTSPOT)
  • 批准号:
    10602502
  • 项目类别:
  • 资助金额:
    $56.19万
  • 财政年份:
    2022
  • 负责人:
    Douglas Scott Krakower
  • 依托单位:
EHR-Based Prediction Models to Improve PrEP Use in Community Health Centers
  • 批准号:
    9926611
  • 项目类别:
  • 资助金额:
    $28.03万
  • 财政年份:
    2019
  • 负责人:
    Douglas Scott Krakower
  • 依托单位:
EHR-Based Prediction Models to Improve PrEP Use in Community Health Centers
  • 批准号:
    10307992
  • 项目类别:
  • 资助金额:
    $23.33万
  • 财政年份:
    2019
  • 负责人:
    Douglas Scott Krakower
  • 依托单位:
海外基金