Brief behavioural counselling by practice nurses improved dietary fat intake, regular exercise, and cigarettes smoked per day at 12 months, but did not significantly change biological risk factors.
RCT (n=883)
Cluster randomized
Yes
Does brief behavioural counselling by practice nurses improve healthy behaviour and biological risk factors in adults at increased risk of coronary heart disease?
Brief behavioural counselling by practice nurses improves self-reported healthy behaviors but does not significantly alter biological risk factors at 12 months in patients at high risk for coronary heart disease.
OBJECTIVE: To measure the effect of behaviourally oriented counselling in general practice on healthy behaviour and biological risk factors in patients at increased risk of coronary heart disease. DESIGN: Cluster randomised controlled trial. PARTICIPANTS: 883 men and women selected for the presence of one or more modifiable risk factors: regular cigarette smoking, high serum cholesterol concentration (6.5-9.0 mmol/l), and high body mass index (25-35) combined with low physical activity. INTERVENTION: Brief behavioural counselling, on the basis of the stage of change model, carried out by practice nurses to reduce smoking and dietary fat intake and to increase regular physical activity. MAIN OUTCOME MEASURES: Questionnaire measures of diet, exercise, and smoking habits, and blood pressure, serum total cholesterol concentration, weight, body mass index, and smoking cessation (with biochemical validation) at 4 and 12 months. RESULTS: Favourable differences were recorded in the intervention group for dietary fat intake, regular exercise, and cigarettes smoked per day at 4 and 12 months. Systolic blood pressure was reduced to a greater extent in the intervention group at 4 but not at 12 months. No differences were found between groups in changes in total serum cholesterol concentration, weight, body mass index, diastolic pressure, or smoking cessation. CONCLUSIONS: Brief behavioural counselling by practice nurses led to improvements in healthy behaviour. More extended counselling to help patients sustain and build on behaviour changes may be required before differences in biological risk factors emerge.
Steptoe et al. (Sat,) conducted a rct in Increased risk of coronary heart disease (n=883). Brief behavioural counselling vs. Control was evaluated on Diet, exercise, smoking habits, blood pressure, serum total cholesterol, weight, body mass index, and smoking cessation. Brief behavioural counselling by practice nurses improved dietary fat intake, regular exercise, and cigarettes smoked per day at 12 months, but did not significantly change biological risk factors.
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