AI Insight
This quasi-experimental study evaluated a four-stage Therapeutic Patient Education (TPE) program for 129 coronary heart disease patients in Tunisia over one year. The intervention group (n=38) showed significantly fewer major cardiovascular events compared to the control group receiving standard care (21.1% vs 59.3%, p<0.001). The TPE program also improved patients' knowledge of cardiovascular risk factors and lipid profiles, with LDL cholesterol decreasing in the intervention group while worsening in controls.
Why it matters
These findings suggest that structured therapeutic education programs can substantially reduce cardiovascular events and improve clinical outcomes in coronary heart disease patients. The results support implementing TPE as part of standard cardiac care, particularly in resource-limited settings where such programs could provide cost-effective secondary prevention.
Understand the Science
by Hela Ghali, Mohamed Ayoub Tlili, Aymen El Hraiech, Jihen Sahli, Sana Bhiri, Saoussen Layouni, Hend Ben Souda, Majdi Karray, Bruno Pavy, Asma Ben Cheikh, Chekib Zedini
Background
Cardiovascular disease (CVD) is a major public health concern globally, including Tunisia. Therapeutic Patient Education (TPE) plays a crucial role in managing CVD and improving patient outcomes. This study aimed to evaluate the impact of a TPE program on the occurrence of major cardiovascular events in patients with coronary heart disease (CHD) in a Tunisian university hospital.
Methods
A quasi-experimental study was conducted over one year, involving 129 patients with CHD. The intervention group (n = 38) received a four-stage TPE program, while the control group (n = 91) received standard care. The control group met the same inclusion and non-inclusion criteria as the intervention group. It was constituted based on a 3:1 ratio. Patients in the intervention and control groups were recruited from the same department and during the same period to ensure comparability. The primary outcome was the occurrence of major cardiovascular events within one year. Secondary outcomes included knowledge, lipid profile, glycated hemoglobin levels, and quality of life.
Results
The occurrence of major cardiovascular events was significantly lower in the intervention group compared to the control group (21.1% vs. 59.3%, p < 0.001). The TPE program was also associated with improvements in knowledge and biological parameters. Knowledge of cardiovascular risk factors increased from 71.1% at baseline to 78.9% immediately post-intervention (p = 0.039), with 60.5% retention at 3 months. The intervention group showed marked improvements in lipid profiles, with LDL cholesterol decreasing from 2.53 ± 1.45 to 1.88 ± 1.11 mmol/L (p < 0.001) and total cholesterol from 4.32 ± 1.47 to 3.75 ± 1.56 mmol/L (p = 0.002) at 3 months. In contrast, the control group demonstrated worsening lipid parameters (LDL: 2.50 ± 1.55 to 2.90 ± 1.60 mmol/L, p = 0.001).
Conclusions
The TPE program was associated with a lower occurrence of major cardiovascular events and improvements in patients’ knowledge and lipid profiles. These findings suggest a potential beneficial effect of structured therapeutic education in patients with CHD.
Trial registration
The study was prospectively registered on the Pan African Clinical Trial Registry within the number PACTR202307694422939. The authors confirm that all ongoing and related trials for this intervention are registered.