EFFECTIVENESS OF A NURSE-BASED INTERVENTION IN A COMMUNITY PRACTICE ON PATIENTS DIETARY-FAT INTAKE AND TOTAL SERUM-CHOLESTEROL LEVEL

Objective: To evaluate the effect of a nurse-based intervention for pa tients with high total cholesterol (TC) levels in a community practice . Design: Clinical trial without a control followed by a nonrandomized control trial. Setting: Suburban primary care practice. Patients: Whi te patients with TC higher than 6.21 mmol/L (240 mg/dL). In the initia l trial, 82 patients with a mean TC level of 6.80 mmol/L (263 mg/dL). Fifty-three preponderantly female patients in the nonrandomized contro l trial with a mean TC level of 6.83 mmol/L (264 mg/dL). Intervention: Counseling by office nurses using the Eating Pattern Assessment Tool and handouts with brand-specific food advice. In the initial study, pa tients attended up to 5 nurse counseling visits. In a follow-up study, intervention patients attending 2 or more counseling sessions were ma tched with other patients in the practice. Main Outcome Measures: Eati ng Pattern Assessment Tool scores in the initial study and TC levels i n both trials. Results: Mean Eating Pattern Assessment Tool scores at baseline in both studies demonstrated that intervention patients were already following a diet consistent with the National Cholesterol Educ ation Program Step I Diet. In the initial study, mean TC levels of the patients declined 2% (P < .05) and mean Eating Pattern Assessment Too l score improved from 23.4 to 20.4 (P < .001). In the follow-up study, the mean TC level of all patients improved significantly (P = .002). However, the improvement of the intervention patients was no better th an that of the comparison patients. Conclusion: The nurse counseling i ntervention was not effective in patients already following a Step I D iet.