# ACHIEVE

> **NIH NIH R34** · DUKE UNIVERSITY · 2024 · $323,551

## Abstract

ABSTRACT
Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in the United States (U.S.)(1).
Statins reduce the risk of cardiovascular events by 30% in those with prior history of ASCVD (2). Despite being
inexpensive and well-tolerated, however, statins are underused in clinical practice, particularly in patients who
identify as Black. A large-scale intervention to improve evidence-based statin initiation among individuals with
ASCVD is needed, particularly for the Black population. To meet this need, we aim to conduct a multi-center,
pragmatic, cluster randomized, controlled trial to assess the impact of a provider- and patient-directed
intervention to increase the prescription of, and adherence to, appropriate statin therapy among those with
ASCVD (ACHIEVE: A Controlled trial to improve use of High IntEnsity statins for Vascular protEction). The
intervention will be pharmacist-led, embedded in commercial payer systems, partnering with the National
Committee for Quality Assurance (NCQA), and with a particular emphasis on improving statin use in the Black
population. Eligible patients and their clinicians will be identified through commercial payer records. The
pharmacist will then work with the patient and the clinician to overcome barriers and to achieve evidence-
based statin therapy and patient adherence to the medication. As with all pragmatic trials that operate outside
of the traditional clinic-based recruitment model, the optimal method to reach and engage both clinicians and
patients in this trial is uncertain. Our objective for this planning grant is to determine whether our strategies for
clinician and patient recruitment yield a high enough degree of engagement, including among Blacks, to justify
moving forward with the larger trial. Our specific aims are: (1) To evaluate our strategy for recruitment and
engagement of providers to participate in this multifaceted intervention to improve statin prescription and
adherence, with the goal of recruiting at least 25% of identified providers. (2) To evaluate our strategy for
recruitment and engagement of patients to participate in this multifaceted intervention to improve statin
prescription and adherence, with the goal of recruiting at least 30% of identified patients overall and within the
Black patient population. To our knowledge, this approach of engaging providers and their patients through
commercial payer networks has not been tried on the scale envisioned for the ACHIEVE trial. Understanding
whether we can recruit clinicians and patients in this setting will benefit not only the ACHIEVE program, but
also future pragmatic trials across therapeutic areas.

## Key facts

- **NIH application ID:** 10918278
- **Project number:** 5R34HL166680-02
- **Recipient organization:** DUKE UNIVERSITY
- **Principal Investigator:** CHRISTOPHER B. GRANGER
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $323,551
- **Award type:** 5
- **Project period:** 2023-09-01 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10918278

## Citation

> US National Institutes of Health, RePORTER application 10918278, ACHIEVE (5R34HL166680-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10918278. Licensed CC0.

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