MAINTENANCE OF CHOLESTEROL REDUCTION USING AUTOMATED TELEPHONE CALLS

A critical problem in the dietary treatment of hypercholesterolemia is the long-term maintenance of cholesterol reduction. A system to maint ain contact and provide feedback through a computer-interactive phone system was used with 115 subjects who completed a four-week diet and b ehavioral cholesterol reduction program. The subjects, mean age 48 yea rs, were 87% non-Hispanic Caucasian and 74.8% were female. They were r andomized to a control or maintenance group. The maintenance group rec eived calls twice a month for six months. Total cholesterol (TC) and w eight (Ib) were obtained before and after a four-week program and afte r the six-month maintenance period. Neither group of subjects with all cholesterol measurements fully maintained initial cholesterol reducti ons (mean TC: in maintenance (n = 48) 248, 221, 231 versus control [n = 43] 243, 224, 232 mg/dL). All (n = 59) of the maintenance subjects u sed the phone system, with 83.3% of a subset evaluating it indicating the phone messages were helpful. Patients (n = 25) with superset of or equal to 5 lb weight loss and 10% TC decrease from baseline had a bet ter maintenance of TC reduction in the maintenance versus control grou p (273, 208, 231 versus 259, 205, 246 mg/dL) (P < .05). We conclude th at (1) maintenance remains a problem for cholesterol-lowering diet int erventions, (2) automated phone calls are capable of maintaining conta ct and providing patient feedback, and (3) this system may help in the maintenance of TC levels for patients who made greater changes.