# SUPPORT-AF IV

> **NIH NIH R01** · UNIV OF MASSACHUSETTS MED SCH WORCESTER · 2022 · $632,662

## Abstract

Project Summary/Abstract
Six million Americans suffer from atrial fibrillation (AF), a heart rhythm abnormality that is increasing in
prevalence and is also a major risk factor for stroke. AF accounts for 15% of ischemic strokes, resulting in
permanent disability in 60% of cases and death in up to 20%. Oral anticoagulation (AC) is effective for AF-
related stroke prevention and the vast majority of AF patients have a guideline-directed indication for oral AC.
Despite this, only half of eligible AF patients receive treatment. This is particularly true among non-white AF
patients, in whom AC use is lower and stroke rates are higher. The proposed project, SUPPORT-AF IV:
Supporting Use of AC through Provider Prompting about Oral Anticoagulation Therapy for AF, will examine the
impact of a novel AC clinical decision support tool within the electronic health record (EHR) on AC prescribing
behaviors among healthcare providers from two distinct health systems who receive it. We will also examine
clinician engagement through provider interviews and detailed study of behaviors using electronic health
record access logs. Finally, we will refine the alert, develop a comprehensive dissemination plan, and create
an implementation toolkit to widen the use of the alert at other learning health systems nationally. Specific
Aims include: Aim 1: (alert enhancement) Enhance alert which will fire when eligible patients (those with AF
and elevated stroke risk not on AC) visit cardiology providers and PCPs; enhancements include links to
educational material, peership resources, and communication tools to use with patients not on AC. Aim 2:
(adherence: AC initiation and persistence) Measure adherence including AC initiation and AC persistence
(staying on AC for one year) in eligible patients (n=2632) of providers randomized to receive vs. not receive
alert ; repeat measurements in the subset of minority patients (n= 402). Aim 3: (mechanism of effect)
Measure association of digital crumbs with AC initiation and persistence; crumbs include alert specific actions
(opening smart set and linking out to patient educational materials, peership resources, and communication
tools), alert specific orders, other orders, and review of access log actions (review of various items - specialist
notes, cardiac testing results, or medication list). Aim 4: (provider and patient satisfaction) Interview
intervention providers (n=20) about satisfaction with alert and AC management; interview patients (n=25)
satisfaction with AC management received from intervention providers. Aim 5: (dissemination and
implementation) Refine alert, develop a comprehensive dissemination plan, and create an implementation
toolkit that captures all lessons learned from measuring effectiveness, mechanism of effect, and provider and
patient satisfaction.
We are applying for the R01 (PA-18-722) - Improving Patient Adherence to Treatment and Prevention
Regimens. Our research team brings together extensive expertise ...

## Key facts

- **NIH application ID:** 10458767
- **Project number:** 5R01HL155343-02
- **Recipient organization:** UNIV OF MASSACHUSETTS MED SCH WORCESTER
- **Principal Investigator:** Alok Kapoor
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $632,662
- **Award type:** 5
- **Project period:** 2021-08-01 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10458767

## Citation

> US National Institutes of Health, RePORTER application 10458767, SUPPORT-AF IV (5R01HL155343-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10458767. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*