Public Health Nutrition

Interventions

A telephone-supported cardiovascular lifestyle programme (CLIP) for lipid reduction and weight loss in general practice patients: a randomised controlled pilot trial

Keren Louise Stuarta1, Belinda Wylda2, Kathryn Bastiaansa2, Nigel Stocksa1, Grant Brinkwortha2, Phil Mohra2 and Manny Noakesa2 c1

a1 Discipline of General Practice, School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, Australia

a2 Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia

Abstract

Objective To evaluate a primary prevention care model using telephone support delivered through an existing health call centre to general practitioner-referred patients at risk of developing CVD, using objective measures of CVD risk reduction and weight loss.

Design Participants were randomised into two groups: (i) those receiving a telephone-supported comprehensive lifestyle intervention programme (CLIP: written structured diet and exercise advice, plus seven telephone sessions with the Heart Foundation Health Information Service); and (ii) those receiving usual care from their general practitioner (control: written general lifestyle advice). Fasting plasma lipids, blood pressure, weight, waist circumference and height were assessed on general practice premises by a practice nurse at Weeks 0 and 12.

Setting Two general practices in Adelaide, South Australia.

Subjects Forty-nine men and women aged 48·0 (sd 5·88) years identified by their general practitioner as being at future risk of CVD (BMI = 33·13 (sd 5·39) kg/m2; LDL cholesterol (LDL-C) = 2·66 (sd 0·92) mmol/l).

Results CLIP participants demonstrated significantly greater reductions in LDL-C (estimated mean (EM) = 1·98 (se 0·17) mmol/l) and total cholesterol (EM = 3·61 (se 0·21) mmol/l) at Week 12 when compared with the control group (EM = 3·23 (se 0·18) mmol/l and EM = 4·77 (se 0·22) mmol/l, respectively). There were no significant treatment effects for systolic blood pressure (F(1,45) = 0·28, P = 0·60), diastolic blood pressure (F(1,43) = 0·52, P = 0·47), weight (F(1,42) = 3·63, P = 0·063) or waist circumference (F(1,43) = 0·32, P = 0·577).

Conclusions In general practice patients, delivering CLIP through an existing telephone health service is effective in achieving reductions in LDL-C and total cholesterol. While CLIP may have potential for wider implementation to support primary prevention of CVD, longer-term cost-effectiveness data are warranted.

(Received May 14 2012)

(Revised October 31 2012)

(Accepted December 10 2012)

(Online publication March 04 2013)

Keywords

  • Telephone support;
  • Weight loss;
  • Lipid reduction;
  • General practice

Correspondence

c1 Corresponding author: Email manny.noakes@csiro.au

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