Objective: To evaluate the impact of a lifestyle intervention in Australian general practice to reduce the risk of vascular disease.
Design, setting and participants: Stratified cluster randomised controlled trial
among 30 general practices in New South Wales from July 2008 to January
2010. Patients aged 40–64 years were invited to participate. The subgroup who
were 40–55 years of age were included only if they had either hypertension or
Intervention: A general practice-based health-check with brief lifestyle
counselling and referral of high-risk patients to a program consisting of one to
two individual visits with an exercise physiologist or dietitian, and six group
Main outcome measures: Outcomes at baseline, 6 and 12 months included the
behavioural and physiological risk factors for vascular disease — self-reported
diet and physical activity, and measured weight, body mass index, waist
circumference, blood lipid and blood sugar levels, and blood pressure.
Results: Of the 3128 patients who were invited, 958 patients (30.6%)
responded and 814 were eligible to participate. Of these, 699 commenced the
study, and 655 remained in the study at 12 months. Physical activity levels
increased to a greater extent in the intervention group than the control group at
6 and 12 months (P = 0.005). There were no other changes in behavioural or
physiological outcomes or in estimated absolute risk of cardiovascular disease
at 12 months. Of the 384 enrolled in the intervention group, 117 patients (30.5%)
attended the minimum number of group program sessions and lost more weight
(mean weight loss, 1.06 kg) than those who did not attend the minimum
number of sessions (mean weight gain, 0.73 kg).
Conclusion: While patients who received counselling by their general
practitioner increased self-reported physical activity, only those who attended
the group sessions sustained an improvement in weight. However, more
research is needed to determine whether group programs offer significant
benefits over individual counselling in general practice.