Patient knowledge of heart risk improves LDL
Explaining coronary risk to patients who are starting cholesterol-lowering treatment will help reduce cholesterol levels, a Canadian study shows.
Researchers randomised 3,053 patients with established cardiovascular
disease (CVD), diabetes mellitus or multiple risk factors for CVD into
two groups. At the start of the trial and at follow-up appointments every
three months, the intervention group received an explanation of his or
her calculated coronary risk (based on a fasting lipid profile) and how
this would change if lipid lowering targets were met. The control group
received standard care, but no explanation of coronary risk.
On average, low density lipid (LDL) levels in the intervention group
reduced by 1.33mmol/L compared with 1.24mmol/L for the control group.
Despite this difference being small, more patients in the intervention
group met national targets
for lowering LDL levels than in the control group.
The authors suggest that the impact could be attributed to an improvement
in compliance with treatment in patients in the intervention group.
The authors accept that the impact of the intervention is small, but
suggest it is nonetheless measurable. In addition, it is risk-free and
provided at almost no extra cost.
They conclude that discussing individual
coronary risk with patients increases the effectiveness of lipid-lowering
treatment when used for primary prevention of cardiovascular events
(Archives
of Internal Medicine 2007;167:2296–303). |
Hospital
Pharmacist