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Optimizing Medications and Lung Health in People With HIV Through Pharmacist-led Proactive E-Consults

Not Yet RecruitingNA

Sponsor: Seattle Institute for Biomedical and Clinical Research

Conditions: HIV, Inhaled Corticosteroid, Proton Pump Inhibitor, Smoking Cessation, Pneumonia

Interventions: E-consult

Countries: United States

People with HIV (PWH) continue to experience elevated risk of community-acquired pneumonia despite effective antiretroviral therapy. Pneumonia contributes to hospitalization, respiratory failure, cardiovascular complications, long-term decline in lung function, and mortality. Several modifiable factors increase this risk, including active smoking, inadequate receipt of respiratory vaccinations, and inappropriate or prolonged use of inhaled corticosteroids (ICS) or proton-pump inhibitors (PPIs). OPTIMIZE Lung-HIV is a multicenter, patient-level randomized controlled hybrid Type 1 effectiveness-implementation trial evaluating whether a proactive, pharmacist-led E-consult intervention can improve evidence-based pulmonary pharmacotherapy for PWH. Pharmacists will review electronic health records, generate tailored recommendations, and pre-enter orders related to smoking cessation pharmacotherapy, vaccinations, and deprescribing of ICS or PPIs. Providers may enact or modify recommendations as clinically appropriate. The trial will assess the proportion of recommendations enacted within 3 months (primary outcome) and at 12 months (maintenance) and will use mixed methods guided by CFIR and RE-AIM to evaluate adoption, feasibility, acceptability, and implementation barriers and facilitators.

Eligibility overview

Sex: ALL

Age: 18 Years to —

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria

Inclusion Criteria:

* PWH on ART for 6 months, receiving care at the VA, and one or more of the following:

  1. Actively smoking
  2. Prescribed ICS for \>90 days
  3. Prescribed a PPI for \>90 days

     Exclusion Criteria:
* Enrolled in palliative care or hospice
* if a non-VA provider is the main primary care or HIV provider
* Are currently participating in a separate ongoing interventional clinical trial

Locations (3)

Boise, Idaho, United States
Minneapolis, Minnesota, United States
Seattle, Washington, United States