Impact of computer-generated personalized goals on cholesterol lowering.
OBJECTIVE
The National Cholesterol Education Program (NCEP) has enhanced public awareness of the importance of cholesterol in the development of heart disease, yet most patients with cardiovascular disease (CVD) do not know or achieve their low-density lipoprotein cholesterol (LDL-C) goals. This randomized, controlled trial was designed to evaluate the impact of a system that provides uniquely formatted laboratory results to patients with CVD on their changes in LDL-C levels.


METHODS
Eighty patients with CVD were randomized to receive standard care or the intervention inclusive of a computer-generated, 11''x17'' color poster depicting an individual's LDL-C status and goals along with personalized steps to aid in goal achievement. Cholesterol profiles were obtained at baseline and 6 months after enrollment. Physicians received standard laboratory reports and were blinded to the randomization.


RESULTS
There were no significant differences between patient groups in age, education level, race, baseline cholesterol levels, comorbidities, or percentage of patients in each group who met their NCEP goal at baseline. Patients receiving intervention tools had significant reductions in LDL-C from baseline compared with patients in the control group. Intervention patients who did not meet NCEP goals at baseline had the greatest reduction in LDL-C, with a mean change from baseline of -21.5 mg/dL (P<0.001) whereas standard care patients had no significant change in the LDL-C levels (-4.6 mg/dL, P=0.28). At study close, 73% of intervention patients reported that their posters remained displayed on their refrigerator.


CONCLUSIONS
This unique and personalized intervention resulted in the LDL-C lowering benefit among patients with CVD comparable to that of lipid lowering agents.
Levetan
Claresa S
CS
Department of Internal Medicine, Lankenau Hospital, Wynnewood, PA 19096, USA. levetan@juno.com
Dawn
Karen R
KR
Murray
James F
JF
Popma
Jeffrey J
JJ
Ratner
Robert E
RE
Robbins
David C
DC
D000328:Adult; D000368:Aged; D000465:Algorithms; D001794:Blood Pressure; D001835:Body Weight; D016507:Cardiology Service, Hospital; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003196:Computer Graphics; D003661:Decision Support Techniques; D018961:Educational Technology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning; D010353:Patient Education as Topic / Q000379:methods*; D015397:Program Evaluation; D012984:Software; D011795:Surveys and Questionnaires
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL