Author:
Pérula Luis A,Bosch Josep M,Bóveda Julia,Campiñez Manuel,Barragán Nieves,Arboniés Juan C,Prados Jose A,Martín Enrique,Martín Remedios,Massons Josep,Criado Margarita,Ruiz Roger,Fernández José A,Buitrago Francisco,Olaya Inmaculada,Pérez Modesto,Ruiz Joaquin
Abstract
Abstract
Background
The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner.
Methods/Design
An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines.
Discussion
Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity.
Trials Registration
ClinicalTrials.gov (NCT01282190).
Publisher
Springer Science and Business Media LLC
Reference37 articles.
1. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al: Cholesterol Treatment Trialists' (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005, 366: 1267-78.
2. Guías de práctica clínica sobre prevención de la enfermedad cardiovascular: versión resumida. Versión corregida el 22/07/2009. Cuarto Grupo de Trabajo Conjunto de la Sociedad Europea de Cardiología y otras Sociedades sobre Prevención de la Enfermedad Cardiovascular en la Práctica Clínica. Rev Esp Cardiol. 2008, 61: e1-e49.
3. San Vicente Blanco R, Pérez Irazusta I, Ibarra Amarica J, Berraondo Zabalegui I, Uribe Oyarbide F, et al: Guía de Práctica Clínica sobre el manejo de los lípidos como factor de riesgo cardiovascular. Osakidetza. 2008, Vitoria-Gasteiz
4. Guies de pràctica clínica de l' ICS: Colesterol i risc coronari. Cited the 20/10/2010, [http://www.gencat.cat/ics/professionals/guies/colesterol/colesterol.htm]
5. Ockene Judith, Kuller Lewis, Svendsen Kenneth, Meilahn Elaine: The Relationship of Smoking Cessation to Coronary Heart Disease and Lung Cancer in the Multiple Risk Factor Intervention Trial (MRFIT). AJPH. 1990, 80 (8):