TY - JOUR AU - Chan, Carrie T.; Vo, Megen; Carlson, Jennifer; Lee, Tzielan; Chang, Marcello; Hart-Cooper, Geoffrey TI - Pediatric Provider Utilization of a Clinical Decision Support Alert and Association with HIV Pre-exposure Prophylaxis Prescription Rates SN - 1869-0327 PY - 2022 JO - Appl Clin Inform JF - Applied Clinical Informatics LA - EN VL - 13 IS - 01 SP - 030 EP - 036 DA - 2022/01/12 KW - clinical decision support KW - electronic health records KW - adolescents KW - CDS alert KW - order set KW - health care system AB - Objectives An electronic clinical decision support (CDS) alert can provide real-time provider support to offer pre-exposure prophylaxis (PrEP) to youth at risk for human immunodeficiency virus (HIV). The purpose of this study was to evaluate provider utilization of a PrEP CDS alert in a large academic-community pediatric network and assess the association of the alert with PrEP prescribing rates.Methods HIV test orders were altered for patients 13 years and older to include a hard-stop prompt asking if the patient would benefit from PrEP. If providers answered “Yes” or “Not Sure,” the CDS alert launched with options to open a standardized order set, refer to an internal PrEP specialist, and/or receive an education module. We analyzed provider utilization using a frequency analysis. The rate of new PrEP prescriptions for 1 year after CDS alert implementation was compared with the year prior using Fisher's exact test.Results Of the 56 providers exposed to the CDS alert, 70% (n = 39) responded “Not sure” to the alert prompt asking if their patient would benefit from PrEP, and 54% (n = 30) chose at least one clinical support tool. The PrEP prescribing rate increased from 2.3 prescriptions per 10,000 patients to 6.6 prescriptions per 10,000 patients in the year post-intervention (p = 0.02).Conclusion Our findings suggest a knowledge gap among pediatric providers in identifying patients who would benefit from PrEP. A hard-stop prompt within an HIV test order that offers CDS and provider education might be an effective tool to increase PrEP prescribing among pediatric providers. PB - Georg Thieme Verlag KG DO - 10.1055/s-0041-1740484 UR - http://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0041-1740484 ER -