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

Harris, Mark F., Fanaian, Mahnaz, Jayasinghe, Upali W., Passey, Megan E., McKenzie, Suzanne, Powell-Davies, Gawaine, Lyle, David M., Laws, Rachel A., Schutze, Heike and Wan, Qing 2012, A cluster randomised controlled trial of vascular risk factor management in general practice, Medical journal of Australia, vol. 197, no. 1, pp. 387-393, doi: 10.5694/mja12.10313.

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Title A cluster randomised controlled trial of vascular risk factor management in general practice
Author(s) Harris, Mark F.
Fanaian, Mahnaz
Jayasinghe, Upali W.
Passey, Megan E.
McKenzie, Suzanne
Powell-Davies, Gawaine
Lyle, David M.
Laws, Rachel A.ORCID iD for Laws, Rachel A. orcid.org/0000-0003-4328-1116
Schutze, Heike
Wan, Qing
Journal name Medical journal of Australia
Volume number 197
Issue number 1
Start page 387
End page 393
Total pages 7
Publisher Australasian Medical Publishing Company
Place of publication Sydney, N.S.W.
Publication date 2012
ISSN 1326-5377
Summary 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.
Language eng
DOI 10.5694/mja12.10313
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 920210 Nursing
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, Australasian Medical Publishing Company
Persistent URL http://hdl.handle.net/10536/DRO/DU:30083495

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