Evaluation of a therapeutic education program for patients with coronary heart disease in a Tunisian university hospital: A quasi-experimental study
9 affiliations
- 1Department of Preventive and Community Medicine, Sahloul University Hospital, Sousse, Tunisia
- 2Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- 3Nursing Administration Department, College of Nursing, University of Hail, Hail, Saudi Arabia
- 4Department of Cardiology, Sahloul University Hospital, Sousse, Tunisia
- 5Department of Family and Community Medicine, Sousse, Tunisia
- 6Department of Physical Rehabilitation, Sahloul University Hospital, Sousse, Tunisia
- 7Family Medicine, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- 8Faculty of Pharmacy of Monastir, University of Monastir, Monastir, Tunisia
- 9Cardiac Rehabilitation Department, Loire-Vendée-Océan Hospital Center, Machecoul, France
Abstract
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.
Related
- Workplace nutrition education promotes sustainable eating and Mediterranean diet adherence among university employees: a quasi-experimental pre-post study
- Effect of animation-based edutainment compared with pamphlet-based education on hand hygiene and HAI prevention among surgical patients: a quasi-experimental study
- Short- and long-term outcome evaluation of a university-based opioid overdose education and naloxone distribution (OEND) program
- A quasi-experimental evaluation of one-to-one counselling to improve mental health and education outcomes amongst school pupils in England, Scotland and Wales
- Prospective evaluation of therapeutic target attainment with a beta-lactam dosing nomogram in critically ill adult patients
BibTeX
@article{ghali2026evaluation,
title = {{Evaluation of a therapeutic education program for patients with coronary heart disease in a Tunisian university hospital: A quasi-experimental study}},
author = {Hela Ghali and Mohamed Ayoub Tlili and Aymen El Hraiech and Jihen Sahli and Sana Bhiri and Saoussen Layouni and Hend Ben Souda and Majdi Karray and Bruno Pavy and Asma Ben Cheikh and Chekib Zedini},
journal = {PLOS One},
year = {2026},
month = nov,
doi = {10.1371/journal.pone.0361814},
url = {https://doi.org/10.1371/journal.pone.0361814},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evaluation of a therapeutic education program for patients with coronary heart disease in a Tunisian university hospital: A quasi-experimental study
AU - Hela Ghali
AU - Mohamed Ayoub Tlili
AU - Aymen El Hraiech
AU - Jihen Sahli
AU - Sana Bhiri
AU - Saoussen Layouni
AU - Hend Ben Souda
AU - Majdi Karray
AU - Bruno Pavy
AU - Asma Ben Cheikh
AU - Chekib Zedini
PY - 2026
DA - 2026/11/09
JO - PLOS One
DO - 10.1371/journal.pone.0361814
UR - https://doi.org/10.1371/journal.pone.0361814
AB - 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.
SN - 1932-6203
ER -