Effectiveness of a nurse-based intervention in a community practice on patients' dietary fat intake and total serum cholesterol level.
OBJECTIVE
To evaluate the effect of a nurse-based intervention for patients with high total cholesterol (TC) levels in a community practice.


METHODS
Clinical trial without a control followed by a nonrandomized control trial.


METHODS
Suburban primary care practice.


METHODS
White patients with TC higher than 6.21 mmol/L (240 mg/dL). In the initial trial, 82 patients with a mean TC level of 6.80 mmol/L (263 mg/dL). Fifty-three preponderantly female patients in the nonrandomized control trial with a mean TC level of 6.83 mmol/L (264 mg/dL).


METHODS
Counseling by office nurses using the Eating Pattern Assessment Tool and handouts with brand-specific food advice. In the initial study, patients attended up to 5 nurse counseling visits. In a follow-up study, intervention patients attending 2 or more counseling sessions were matched with other patients in the practice.


METHODS
Eating Pattern Assessment Tool scores in the initial study and TC levels in both trials.


RESULTS
Mean Eating Pattern Assessment Tool scores at baseline in both studies demonstrated that intervention patients were already following a diet consistent with the National Cholesterol Education Program Step I Diet. In the initial study, mean TC levels of the patients declined 2% (P < .05) and mean Eating Pattern Assessment Tool score improved from 23.4 to 20.4 (P < .001). In the follow-up study, the mean TC level of all patients improved significantly (P = .002). However, the improvement of the intervention patients was no better than that of the comparison patients.


CONCLUSIONS
The nurse counseling intervention was not effective in patients already following a Step I Diet.
Pine
D A
DA
Department of Family Practice, Park Nicollet Medical Center, Minneapolis, MN, USA.
Madlon-Kay
D J
DJ
Sauser
M
M
D000328:Adult; D000368:Aged; D002784:Cholesterol / Q000097:blood*; D004041:Dietary Fats / Q000008:administration & dosage*; D005194:Family Practice; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood* / Q000178:diet therapy / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009726:Nurses; D009819:Office Visits; D010353:Patient Education as Topic; D018881:Suburban Health; D016896:Treatment Outcome
D004041:Dietary Fats; D002784:Cholesterol