Impact of computer-generated personalized goals on cholesterol lowering

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.

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.

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.

This unique and personalized intervention resulted in the LDL-C lowering benefit among patients with CVD comparable to that of lipid lowering agents.