Effect of an educational program (PEGASE) on cardiovascular risk in hypercholesterolaemic patients.
BACKGROUND
Many studies have demonstrated a gap between guidelines for the prevention of cardiovascular disease (CVD) and their implementation in clinical practice.


OBJECTIVE
The PEGASE education program has been devised with an aim to improve the management of patients at high risk of CVD.


METHODS
In a multicentre study carried out from 2001-2004 in France, 96 participating physicians were randomized into a "trained" group, which included 398 "educated" patients, and a "non-trained" group, which included 242 "non-educated" patients. Educated patients received six hospital-based educational sessions, four collective and two individual. Framingham score, smoking, lipid levels, glycaemia, blood pressure, dietary intake and drug compliance, as well as quality of life, were evaluated at baseline (M0) and 6 months (M6). The primary endpoint of the study was the efficacy of the PEGASE program in reducing global CVD risk in high-risk patients.


RESULTS
The Framingham score was calculated for 473 patients. The Framingham score improved significantly at M6 vs M0 in the educated group (13.0 +/- 8.21 vs 13.6 +/- 8.48, d = -0.658, p = 0.016), but not in the non-educated group (12.5 +/- 8.19 vs 12.4 +/- 7.81, d = +0.064, p = 0.836); the mean change between the two groups did not reach significance. Quality of life, LDL-c level and diet scores improved in the "educated" group only.


CONCLUSIONS
The PEGASE education program improved risk factors for CVD, although global assessment by Framingham score was not significantly different between groups. This program, aimed at meeting needs and expectations of patients and physicians, was easily implemented in all hospital centres.
Bruckert
Eric
E
Groupe hospitalier Pitié-Salpétrière, Service d'Endocrinologie-Métabolisme, 47-83, Boulevard de l'Hôpital, 75651 Paris Cedex 13, France. eric.bruckert@psl.aphp.fr
Giral
Philippe
P
Paillard
François
F
Ferrières
Jean
J
Schlienger
Jean-Louis
JL
Renucci
Jean-François
JF
Abdennbi
Kamel
K
Durack
Isabelle
I
Chadarevian
Rita
R
D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D004502:Education, Medical, Continuing / Q000379:methods; D005247:Feeding Behavior; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D011369:Professional-Patient Relations; D011788:Quality of Life; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D017749:Total Quality Management / Q000639:trends
D008078:Cholesterol, LDL