Evaluation of a therapeutic education program for patients with coronary heart disease in a Tunisian university hospital: A quasi-experimental study

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.