ROYBAL ALL-HANDS MEETING

Investigative Team: Julie Lauffenburger, PharmD, PhD, Marie McDonnell, MD, Punam Keller, MBA, PhD, Elad Yom-Tov, MA, PhD, and Niteesh Choudhry, MD, PhD This pilot seeks to evaluate the feasibility and effectiveness of a machine-learning based approach to optimize and personalize medication adherence health communication for patients with diabetes. The project consists of a pragmatic trial. We also seek to cluster intervention patients by their response to different types of messages and evaluate the ability to predict these cluster phenotypes using information prior to randomization.

Investigative Team: Candace Feldman, MD, MPH, ScD, Wendy Wood, PhD, Niteesh Choudhry, MD, PhD, Robert Glynn, PhD, ScD, and Ted Robertson, MPA This pilot aims to evaluate the feasibility and effectiveness of a habit formation intervention to motivate medication adherence for patients with rheumatic conditions. We are conducting a pragmatic randomized trial to determine whether strategies that couple context cues and intermittent rewards improve medication adherence in rheumatic patients.

Investigative Team: Nancy Haff, MD, MPH, Niteesh Choudhry, MD, PhD, Wendy Wood, PhD, and Elad Yom-Tov, PhD This pilot seeks to empirically identify factors contributing to clinical inertia and to identify the relationship between these factors and intervention responsiveness. To achieve this, we will test two interventions targeting inertia (social norming and academic e-detailing) compared to control in a pragmatic, randomized pilot study. We will then identify intervention responsiveness profiles through patient and physician clustering using a machine learning approach.

Investigative Team: Julie Lauffenburger, PharmD, PhD, Niteesh Choudhry, MD, PhD, Jerry Avorn, MD, and Ted Robertson, MPA This pilot aims to reduce the prescribing of high-risk medications, such as antipsychotics and benzodiazepines, to hospitalized older adults. We hypothesize that the use of these medications is driven by "system 1" thinking and that prescribing can be improved using simulation training. We are conducting a pilot randomized trial to evaluate the effectiveness of the simulation approach that we developed.

Investigative Team: Nancy Haff, MD, MPH, Julie Lauffenburger, PharmD, PhD, Punam Keller, PhD, MBA, and Niteesh Choudhry, MD, PhD This randomized trial tests the effects of "how" versus "why: message framing on COVID-19 vaccination rates using electronically delivered communication, followed by analyses to identify patient characteristics that might predict intervention responsiveness to allow for further tailored communication after the completion of the trial.

Investigative Team: Amar Dhand, MD, DPhil, Niteesh Choudhry, MD, PhD, and Nancy Haff, MD, MPH This project aims to leverage social networks to improve hypertension control. We are conducting a randomized trial to determine the effects of a social networks intervention versus individual hypertension counseling on blood pressure control for patients discharged after ischemic stroke. We also aim to determine the shortest questionnaire that maximizes network information important for the intervention versus the previously validated full version.

Investigative Team: Candace Feldman, MD, MPH, ScD, Niteesh Choudhry, MD, PhD, Nao Hagiwara, PhD, and Sara Schoenfeld, MD The goal of this pilot is to test the efficacy of an individuation-based intervention among rheumatologists and racially discordant patients at two large, multisite practices to improve racial and SES equity in receipt of high-quality care. We will conduct a pragmatic randomized trial to test the efficact of a real-time, provider-based individuation intervention versus standard of care to improve the receipt of high-quality rheumatic disease care among Black and lower socioeconomic status individuals. We will also evaluate the effect of the intervention on provider-patient communication, adherence, provider trust and care satisfaction.