Implementation of strategy for the management of overt dyslipidemia: The IMPROVE-dyslipidemia study A.I. Hatzitolios a, ⁎ , V.G. Athyros b , A. Karagiannis b , C. Savopoulos a , C. Charalambous c , G. Kyriakidis d , Th. Milidis e , C. Papathanakis f , A. Bitli g , I. Vogiatsis h , G. Ntaios a , N. Katsiki a , A. Symeonidis i , K. Tziomalos j , D.P. Mikhailidis j for the IMPROVE Collaborative Group a 1st Propedeutic Department of Internal Medicine, Aristotelian University, AHEPA Hospital, Thessaloniki, Greece b Atherosclerosis and Metabolic Syndrome Units, 2nd Propedeutic Department of Internal Medicine, Aristotelian University, Hippocration Hospital, Thessaloniki, Greece c Internal Medicine Clinic, Psychiatric Hospital, Thessaloniki, Greece d Internal Medicine Clinic, Agios Dimitrios Hospital, Thessaloniki, Greece e Internal Medicine Clinic, Serres Hospital, Serres, Greece f Health Centre of Orestiada, Orestiada, Greece g Internal Medicine Clinic, Kilkis Hospital, Kilkis, Greece h Cardiology Clinic, Veria Hospital, Veria, Greece i Health Centre of Paleohoriou, Chalkidiki, Greece j Department of Clinical Biochemistry, Royal Free Hospital Campus, University College Medical School, University College London, Pond Street, London NW3 2QG, UK Received 18 September 2008; received in revised form 21 November 2008; accepted 6 February 2009 Available online 6 March 2009 Abstract Background: To assess the efficacy of a strategy aimed at improving vascular risk management in patients with dyslipidemia with or without cardiovascular disease (CVD). Methods: This is a pilot implementation enhancement program that was evaluated in 1127 patients with dyslipidemia. There was a baseline visit, followed by a concerted effort from previously trained physicians to improve adherence to lifestyle advice and optimize drug treatment for all vascular risk factors. After 6 months the patients were re-evaluated. The PROspective-Cardiovascular-Munster (PROCAM) and Framingham trials risk engines were used to estimate CVD risk in primary prevention patients (n = 609). Results: This strategy induced a better compliance to lifestyle measures and use of evidence-based medication, focusing on statins. This resulted in a 45% (Framingham) to 63% (PROCAM) reduction in estimated CVD risk in primary prevention (both p b 0.0001). There was also a substantial increase in the proportion of secondary prevention patients (n = 518) achieving CVD risk factor targets (from 29% at baseline to 76% at 6 months, p b 0.0001). Conclusions: This is the first study to increase the adherence to multiple interventions in patients with dyslipidemia, and other CVD risk factors, in both primary care and teaching hospital settings. Simple measures, such as educating physicians and patients, distributing printed guidelines and brochures, and completing a 1-page form, motivated physicians and patients to achieve multiple CVD risk factor goals. © 2009 Elsevier Ireland Ltd. All rights reserved. Keywords: Dyslipidemia; Treatment; Control; Best practice; Public health care International Journal of Cardiology 134 (2009) 322 – 329 www.elsevier.com/locate/ijcard ⁎ Corresponding author. 1 Stilponos Kyriakidi Street, Thessaloniki, 546 36, Greece. Tel.: +30 2310 993480; fax: +30 2310994918. E-mail address: axatzito@med.auth.gr (A.I. Hatzitolios). 0167-5273/$ - see front matter © 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2009.02.001