title: Implementation of strategy for the management of overt dyslipidemia: the IMPROVE-dyslipidemia study.
abstract: BACKGROUND
  To assess the efficacy of a strategy aimed at improving vascular risk management in patients with dyslipidemia with or without cardiovascular disease (CVD).
  
  
  METHODS
  This is a pilot implementation enhancement program that was evaluated in 1127 patients with dyslipidemia. There was a baseline visit, followed by a concerted effort from previously trained physicians to improve adherence to lifestyle advice and optimize drug treatment for all vascular risk factors. After 6 months the patients were re-evaluated. The PROspective-Cardiovascular-Munster (PROCAM) and Framingham trials risk engines were used to estimate CVD risk in primary prevention patients (n=609).
  
  
  RESULTS
  This strategy induced a better compliance to lifestyle measures and use of evidence-based medication, focusing on statins. This resulted in a 45% (Framingham) to 63% (PROCAM) reduction in estimated CVD risk in primary prevention (both p<0.0001). There was also a substantial increase in the proportion of secondary prevention patients (n=518) achieving CVD risk factor targets (from 29% at baseline to 76% at 6 months, p<0.0001).
  
  
  CONCLUSIONS
  This is the first study to increase the adherence to multiple interventions in patients with dyslipidemia, and other CVD risk factors, in both primary care and teaching hospital settings. Simple measures, such as educating physicians and patients, distributing printed guidelines and brochures, and completing a 1-page form, motivated physicians and patients to achieve multiple CVD risk factor goals.
authors.affiliation: 1st Propedeutic Department of Internal Medicine, Aristotelian University, AHEPA Hospital, Thessaloniki, Greece. axatzito@med.auth.gr
authors.forename: A I
authors.initials: AI
authors.lastname: Hatzitolios
authors.forename: V G
authors.initials: VG
authors.lastname: Athyros
authors.forename: A
authors.initials: A
authors.lastname: Karagiannis
authors.forename: C
authors.initials: C
authors.lastname: Savopoulos
authors.forename: C
authors.initials: C
authors.lastname: Charalambous
authors.forename: G
authors.initials: G
authors.lastname: Kyriakidis
authors.forename: Th
authors.initials: T
authors.lastname: Milidis
authors.forename: C
authors.initials: C
authors.lastname: Papathanakis
authors.forename: A
authors.initials: A
authors.lastname: Bitli
authors.forename: I
authors.initials: I
authors.lastname: Vogiatsis
authors.forename: G
authors.initials: G
authors.lastname: Ntaios
authors.forename: N
authors.initials: N
authors.lastname: Katsiki
authors.forename: A
authors.initials: A
authors.lastname: Symeonidis
authors.forename: K
authors.initials: K
authors.lastname: Tziomalos
authors.forename: D P
authors.initials: DP
authors.lastname: Mikhailidis
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000628:therapy; D015331:Cohort Studies; D038441:Diet, Mediterranean; D019468:Disease Management; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012307:Risk Factors