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

Recruiting

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

Who can join

Ages 18 and older · All sexes

Full eligibility criteria

Inclusion Criteria:

* PWH with an active prescription of ART any time in past 6 months and \<200 copies/mL within past 12 months, actively receiving care at the VA, and one 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

About the study

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.

What is being tested

E-consult (other)

Sponsor: Seattle Institute for Biomedical and Clinical Research · Participants: 480 · Started: Sep 24, 2026

Contact the study team

John R Kundzins, BS · Phone: 206-277-1182

Official record on ClinicalTrials.gov — NCT07507435

Locations in the U.S.

Idaho	Boise VA Medical Center, Boise (Not yet recruiting)
Minnesota	Minneapolis VA Health Care System, Minneapolis (Not yet recruiting)
Washington	VA Puget Sound Health Care System, Seattle

Conditions

From ClinicalTrials.gov, data retrieved Nov 15, 2026. Each study sets its own eligibility; the study team decides who can join.