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A cluster randomised controlled trial of vascular risk factor management in general practice

Journal Article


Abstract


  • 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

    dyslipidaemia.

    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

    sessions.

    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.

UOW Authors


  •   Harris, Mark Fort. (external author)
  •   Fanaian, Mahnaz (external author)
  •   Jayasinghe, Upali W. (external author)
  •   Passey, Megan (external author)
  •   Mckenzie, Suzanne H. (external author)
  •   Davies, G (external author)
  •   Lyle, David (external author)
  •   Laws, Rachel A. (external author)
  •   Schutze, Heike
  •   Wan, Qing (external author)

Publication Date


  • 2012

Citation


  • Harris, M. F., Fanaian, M., Jayasinghe, U. W., Passey, M., Mckenzie, S., Davies, G., Lyle, D., Laws, R. A., Schutze, H. & Wan, Q. (2012). A cluster randomised controlled trial of vascular risk factor management in general practice. Medical Journal of Australia, 197 (7), 387-393.

Scopus Eid


  • 2-s2.0-84871917895

Ro Metadata Url


  • http://ro.uow.edu.au/ihmri/225

Has Global Citation Frequency


Number Of Pages


  • 6

Start Page


  • 387

End Page


  • 393

Volume


  • 197

Issue


  • 7

Place Of Publication


  • Australia

Abstract


  • 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

    dyslipidaemia.

    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

    sessions.

    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.

UOW Authors


  •   Harris, Mark Fort. (external author)
  •   Fanaian, Mahnaz (external author)
  •   Jayasinghe, Upali W. (external author)
  •   Passey, Megan (external author)
  •   Mckenzie, Suzanne H. (external author)
  •   Davies, G (external author)
  •   Lyle, David (external author)
  •   Laws, Rachel A. (external author)
  •   Schutze, Heike
  •   Wan, Qing (external author)

Publication Date


  • 2012

Citation


  • Harris, M. F., Fanaian, M., Jayasinghe, U. W., Passey, M., Mckenzie, S., Davies, G., Lyle, D., Laws, R. A., Schutze, H. & Wan, Q. (2012). A cluster randomised controlled trial of vascular risk factor management in general practice. Medical Journal of Australia, 197 (7), 387-393.

Scopus Eid


  • 2-s2.0-84871917895

Ro Metadata Url


  • http://ro.uow.edu.au/ihmri/225

Has Global Citation Frequency


Number Of Pages


  • 6

Start Page


  • 387

End Page


  • 393

Volume


  • 197

Issue


  • 7

Place Of Publication


  • Australia