Key result
A lifestyle intervention with telephone counselling significantly reduced the Framingham risk score compared to usual care in primary prevention patients (-3.10 vs -1.30; P<0.01).
Why the study?
Does a health report card combined with Telehealth lifestyle counselling improve the Framingham global risk score in mid-life individuals at risk for or with cardiovascular disease?
RCT (n=611)
Does a health report card combined with Telehealth lifestyle counselling improve the Framingham global risk score in mid-life individuals at risk for or with cardiovascular disease?
A low-intensity lifestyle intervention using health report cards and telehealth counseling significantly improved cardiovascular risk scores in primary prevention patients, but not in secondary prevention patients.
Answers are grounded in this paper and cite their sources.
Supports telehealth lifestyle counselling in primary CVD prevention; extends RCT evidence on modifiable risk scores.
BACKGROUND: In this study, we tested the efficacy of a low-intensity lifestyle intervention aimed at reducing the risk of cardiovascular disease among mid-life individuals. METHODS: We conducted a randomized controlled trial in which participants were randomly assigned either to receive a health report card with counselling (from a Telehealth nurse) on smoking, exercise, nutrition and stress or to receive usual care. The patients were divided into 2 groups on the basis of risk: the primary prevention group, with a Framingham risk score of 10% or higher (intervention, n = 157; control, n = 158), and the secondary prevention group, who had a diagnosis of coronary artery disease (intervention, n = 153; control, n = 143). The primary outcome was a change in the Framingham global risk score between baseline and 1-year follow-up. Data were analyzed separately for the 2 prevention groups using an intention-to-treat analysis controlling for covariates. RESULTS: Within the primary prevention group, there were statistically significant changes for the treatment group relative to the controls, from baseline to year 1, in Framingham score (intervention, -3.10 [95% confidence interval (CI) -3.98 to -2.22]; control, -1.30 [95% CI -2.18 to -0.42]; p < 0.01) and scores for total cholesterol (intervention, -0.41 [95% CI -0.59 to -0.23]; control, -0.14 [95% CI -0.32 to 0.04]; p < 0.05), systolic blood pressure (intervention, -7.49 [95% CI -9.97 to -5.01]; control, -3.58 [95% CI -6.08 to -1.08]; p < 0.05), nutrition level (intervention, 0.30 [95% CI 0.13 to 0.47]; control, -0.05 [95% CI -0.22 to 0.12]; p < 0.01), and health confidence (intervention, 0.20 [95% CI 0.09 to 0.31]; control, 0.04 [95% CI -0.07 to 0.15]; p < 0.05), with adjustment for covariates. No significant changes in outcome variables were found for the secondary prevention group. INTERPRETATION: We found evidence for the efficacy of an intervention addressing multiple risk factors for primary prevention at 1 year using Framingham risk score report cards and telephone counselling. (Requirement for clinical trial registration waived [enrolment completed before requirement became applicable].).
No takes yet. Share an insight, caveat, or question.
Wister et al. (2007) conducted an RCT in Cardiovascular disease risk (n=611). Health report card with telephone counselling on smoking, exercise, nutrition and stress vs. Usual care was evaluated on Change in the Framingham global risk score between baseline and 1-year follow-up (p=<0.01). A lifestyle intervention with telephone counselling significantly reduced the Framingham risk score compared to usual care in primary prevention patients (-3.10 vs -1.30; P<0.01).
Synapse has enriched 10 related papers. Consider them for comparative context: