Da. Pine et al., EFFECTIVENESS OF A NURSE-BASED INTERVENTION IN A COMMUNITY PRACTICE ON PATIENTS DIETARY-FAT INTAKE AND TOTAL SERUM-CHOLESTEROL LEVEL, Archives of family medicine, 6(2), 1997, pp. 129-134
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.