黄金EDU:一个教育干预的集群随机试验,以改善降脂指南的坚持
Christopher P Cannon1, Christie M Ballantyne2, Deepak L Bhatt3
1Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
在动脉样硬化心血管疾病 (ASCVD) 患者中,对降脂疗法 (LLT) 的医生教育并没有改善低密度脂蛋白胆固醇 (LDL-C) 目标的实现. 需要新的策略来增强LLT优化和降低ASCVD事件风险.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 临床研究 临床研究
背景情况:
- 对降脂疗法 (LLT) 准则的不理想遵守有助于控制低密度脂蛋白胆固醇 (LDL-C) 的不良控制.
- 这种低于最佳的控制增加了动脉样硬化心血管疾病 (ASCVD) 事件的风险.
研究的目的:
- 评估以医生为中心的教育干预对优化LLT的有效性.
- 这项干预旨在改善LDL-C目标在ASCVD患者的一年内.
主要方法:
- 延长GOULD (获得对低密度脂蛋白胆固醇和失脂症管理的更好理解) 注册表的一年.
- 集群随机化,阶段式形设计,为医生提供教育干预 (网络研讨会,数据报告).
- 结果包括LLT的变化,LDL-C测量频率,LDL-C水平和目标实现.
主要成果:
- 干预组和对照组之间的LLT强化没有显著差异.
- 在研究期间,只有7.0%的患者经历了LLT强化.
- 达成的LDL-C目标仍然很低,39.5%的患者在1年内达到70mg/dL以下的目标.
结论:
- 在ASCVD患者中,教育干预对LLT优化和LDL-C目标实现的影响最小.
- 目前的教育方法不足以改善LDL-C目标的实现.
- 需要新的策略,以有效地管理失脂血症并降低ASCVD风险.
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