Educational intervention for 1 year did not help patients achieve LDL goals
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A 1-year clinician educational intervention did not improve achievement of LDL goals in patients with atherosclerotic CVD, researchers reported at the National Lipid Association Scientific Sessions.
The GOULD EDU 1-year extension study was conducted in certain patients with ASCVD on any lipid-lowering therapy who had completed the 2-year GOULD study. As Healio previously reported, in GOULD, fewer than 20% of patients with ASCVD had their lipid-lowering therapy intensified and approximately 30% achieved an LDL goal of less than 70 mg/dL.
“We wanted to assess whether health care practitioner education would result in improved lipid management, so we extended the GOULD study to allow trial sites to participate in peer-to-peer education to assess the impact that heath care practitioner education might have on lipid management,” Belinda Schludi, PhD, RPh, medical director and global medical affairs lead for Repatha (evolocumab) at Amgen, which sponsored the study, told Healio.
For GOULD EDU, presented by Christie M. Ballantyne, MD, FACC, FACP, FAHA, FNLA, chief of the sections of cardiology and cardiovascular research and professor of medicine at Baylor College of Medicine, 30 sites with 616 patients were cluster-randomized to an early educational intervention (STEP 1) and 26 sites with 382 patients were cluster-randomized to a late educational intervention (STEP 2).
In both cases, the intervention consisted of two live webinars for clinicians covering lipid-lowering therapy guidelines, patterns of lipid-lowering therapy use and LDL control in the U.S. and opportunities for improvement. All sites received reports of site-specific lipid-lowering therapy use and LDL control patterns three times during the intervention period.
The researchers used chart reviews to determine changes in lipid-lowering therapy use, results of LDL tests and achievement of the LDL goal of less than 70 mg/dL.
Changes in lipid-lowering therapy use were minimal during the study period, with 83.6% of patients having no change during that time, Ballantyne and colleagues found.
In the STEP 1 group, 36.9% achieved the LDL goal at the end of the study, down from 38.5% at baseline, while in the STEP 2 group, 44.5% achieved the LDL goal at the end of the study, up slightly from 39.3% at baseline.
“The 1-year duration may have been insufficient to measure change in clinical practice patterns, and other more intensive interventions and changes in clinical care delivery models may be required to address the complex reasons for suboptimal adherence to guidelines,” the researchers wrote on the abstract poster.
“This suggests that education alone was insufficient to improving guideline adherence and lipid management and underscores the need for more innovative strategies to make a meaningful impact on helping patients achieve LDL goals in accordance with the guidelines,” Schludi told Healio. “GOULD and GOULD EDU highlight the gaps in care and the need for improved patient awareness around LDL goals. It is our goal at Amgen to uncover the barriers surrounding lipid management to better understand how to improve this for high-risk patients while raising awareness about treatment guidelines and elevating conversations around them.”
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Ballantyne CM, et al. Abstract 43. Presented at: National Lipid Association Scientific Sessions; June 2-5, 2022; Scottsdale, Arizona (hybrid meeting).
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