title: Activating peripheral arterial disease patients to reduce cholesterol: a randomized trial.
abstract: BACKGROUND
  Peripheral arterial disease patients are less likely than other high-risk patients to achieve ideal low-density lipoprotein (LDL) cholesterol levels. This randomized controlled trial assessed whether a telephone counseling intervention, designed to help peripheral arterial disease patients request more intensive cholesterol-lowering therapy from their physician, achieved lower LDL cholesterol levels than 2 control conditions.
  
  
  METHODS
  There were 355 peripheral arterial disease participants with baseline LDL cholesterol ≥70 mg/dL enrolled. The primary outcome was change in LDL cholesterol level at 12-month follow-up. There were 3 parallel arms: telephone counseling intervention, attention control condition, and usual care. The intervention consisted of patient-centered counseling, delivered every 6 weeks, encouraging participants to request increases in cholesterol-lowering therapy from their physician. The attention control condition consisted of telephone calls every 6 weeks providing information only. The usual care condition participated in baseline and follow-up testing.
  
  
  RESULTS
  At 12-month follow-up, participants in the intervention improved their LDL cholesterol level, compared with those in attention control (-18.4 mg/dL vs -6.8 mg/dL, P=.010) but not compared with those in usual care (-18.4 mg/dL vs -11.1 mg/dL, P=.208). Intervention participants were more likely to start a cholesterol-lowering medication or increase their cholesterol-lowering medication dose than those in the attention control (54% vs 18%, P=.001) and usual care (54% vs 31%, P <.001) conditions.
  
  
  CONCLUSIONS
  Telephone counseling that helped peripheral arterial disease patients request more intensive cholesterol-lowering therapy from their physician achieved greater LDL cholesterol decreases than an attention control arm that provided health information alone.
authors: Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. mdm608@northwestern.edu
authors: Mary M
authors: MM
authors: McDermott
authors: George
authors: G
authors: Reed
authors: Philip
authors: P
authors: Greenland
authors: Kathy M
authors: KM
authors: Mazor
authors: Sherry
authors: S
authors: Pagoto
authors: Judith K
authors: JK
authors: Ockene
authors: Rex
authors: R
authors: Graff
authors: Philip A
authors: PA
authors: Merriam
authors: Kathy
authors: K
authors: Leung
authors: Larry
authors: L
authors: Manheim
authors: Melina R
authors: MR
authors: Kibbe
authors: Barbara
authors: B
authors: Olendzki
authors: William H
authors: WH
authors: Pearce
authors: Ira S
authors: IS
authors: Ockene
references: Am J Cardiol. 2003 Jul 15;92(2):152-60
references: 12860216
references: Atherosclerosis. 2006 Nov;189(1):61-9
references: 16620828
references: Arch Intern Med. 2003 Oct 13;163(18):2157-62
references: 14557213
references: Med Care. 2004 Jul;42(7):649-52
references: 15213489
references: Pharmacotherapy. 2004 Mar;24(3):324-37
references: 15040645
references: Hypertens Res. 2008 Nov;31(11):2037-43
references: 19098375
references: J Contin Educ Health Prof. 2002 Winter;22(1):11-22
references: 12004636
references: J Gen Intern Med. 2002 Dec;17(12):895-904
references: 12472925
references: Patient Educ Couns. 1999 Jun;37(2):113-24
references: 14528539
references: Arch Intern Med. 2003 Jul 28;163(14):1673-81
references: 12885682
references: J Clin Epidemiol. 2002 Mar;55(3):245-52
references: 11864795
references: JAMA. 2001 Sep 19;286(11):1317-24
references: 11560536
references: Arch Fam Med. 1997 Sep-Oct;6(5):453-8
references: 9305688
references: JAMA. 1999 Jan 27;281(4):382-4
references: 9929096
references: J Am Coll Cardiol. 2004 Aug 4;44(3):720-32
references: 15358046
references: JAMA. 2008 Jul 9;300(2):197-208
references: 18612117
references: Health Serv Res. 2004 Aug;39(4 Pt 1):1005-26
references: 15230939
references: Am J Cardiol. 1998 Mar 1;81(5):582-7
references: 9514454
references: J Gen Intern Med. 1997 Apr;12(4):209-15
references: 9127224
references: Am J Cardiol. 1999 May 15;83(10):1476-7, A7
references: 10335764
references: Circulation. 2009 Jul 7;120(1):28-34
references: 19546386
references: J Am Geriatr Soc. 1998 Jul;46(7):889-94
references: 9670878
references: Vasc Med. 2010 Apr;15(2):83-90
references: 20118170
references: JAMA. 2009 Jan 14;301(2):165-74
references: 19141764
references: Am J Clin Nutr. 1979 Dec;32(12):2546-59
references: 506977
references: Atherosclerosis. 2008 Dec;201(2):425-33
references: 18395208