Wednesday, January 28, 2026 1/28/2026

AdvanCing High quality COPD care for people with immune dysfunction by implementing Evidence-based management through proactive E-consults (ACHIEVE)

Award Number: U01HL142103
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2018
PERIOD OF PERFORMANCE END DATE: 05/31/2025

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AdvanCing High quality COPD care for people with immune dysfunction by implementing Evidence-based management through proactive E-consults (ACHIEVE) - Abstract As HIV-infected (HIV+) patients age, chronic obstructive pulmonary disease (COPD) is one of the most prevalent comorbid diseases. Of concern among patients with HIV infection, COPD confers substantial morbidity and is associated with increased mortality. Yet, COPD is underdiagnosed and often inappropriately managed in HIV+ patients, likely worsening the morbidity associated with COPD. Optimizing the management of COPD includes improving uptake of recommended and discontinuation of ineffective and harmful practices. Accurate diagnosis of COPD can identify individuals who will benefit – and those who will not benefit – from COPD therapies. Appropriate use of long-acting inhalers to control COPD improves symptoms, health-related quality of life, functional status, and decrease risk for exacerbations. Discontinuation of inappropriate inhalers – particularly inhaled corticosteroids – can minimize harms from side effects that may be particularly problematic in HIV+ persons, given their concomitant immuno-compromise, multimorbidity, and polypharmacy. We propose to test an intervention to optimize COPD care that promotes effective, evidence-based care and de-implements inappropriate therapies for COPD in HIV+ patients. We are a multidisciplinary team of key stakeholders and investigators with expertise in COPD, HIV and implementation science, with prior experience studying similar interventions. The intervention, grounded in the chronic care model, facilitates specialist support of primary care, which includes infectious disease (ID) physicians who serve as the primary care providers for their HIV+ patients in the ID clinic. Rather than relying on referral-driven specialty care, which may be a barrier to access, we will have pulmonologists proactively support HIV providers to manage a population of HIV+ patients with COPD, delivering real-time evidence-based recommendations tailored to the individual HIV+ patient. We will leverage the Department of Veterans Affairs (VA) clinical and informatics infrastructures to communicate between team members developing the recommendations and patients' clinical providers through the electronic health record as a proactive (i.e., pulmonary-initiated) E-consult. To offset potential increases in ID providers' workload, we will draft recommendations as preliminary orders for providers to review and endorse (sign), modify or cancel at their discretion, preserving autonomy. We will use a modified stepped-wedge intervention design, with outcomes evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework. We will evaluate barriers and facilitators of optimal COPD care for HIV+ patients, and of effective adoption, implementation and maintenance of a proactive E-consult program, guided by the Consolidated Framework for Implementation Research. This intervention can enhance the sustainable uptake of proven-effective interventions into routine clinical practice for HIV+ patients, who are at risk of disparities in COPD care and poor health outcomes from COPD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = -$3,854 )
2026	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	12/4/2025	NON-COMPETING CONTINUATION	-$3,854
														Subtotal = -$3,854

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	5/17/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	4	4/18/2023	NON-COMPETING CONTINUATION	$0
2023	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	3/31/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	1/10/2022	NON-COMPETING CONTINUATION	$0
2022	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	4	8/10/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $658,660 )
2021	2021	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	6/7/2021	NON-COMPETING CONTINUATION	$658,660
														Subtotal = $658,660

Issue Date FY: 2020 ( Subtotal = $681,154 )
2020	2020	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	3	5/21/2020	NON-COMPETING CONTINUATION	$681,154
2020	2019	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	2	2/11/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $681,154

Issue Date FY: 2019 ( Subtotal = $693,541 )
2019	2019	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	2	6/26/2019	NON-COMPETING CONTINUATION	$693,541
2019	2018	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	1	12/7/2018	NEW	$0
														Subtotal = $693,541

Issue Date FY: 2018 ( Subtotal = $740,256 )
2018	2018	SEATTLE INSTITUTE FOR BIOMEDICAL AND CLINICAL RESEARCH	1660 S COLUMBIAN WAY # 151F	SEATTLE	WA	98108	KING	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	1	8/16/2018	NEW	$740,256
														Subtotal = $740,256

Grand Total All Awards = $2,769,757

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AdvanCing High quality COPD care for people with immune dysfunction by implementing Evidence-based management through proactive E-consults (ACHIEVE)

Award Number: U01HL142103

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2018

PERIOD OF PERFORMANCE END DATE: 05/31/2025

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