title: A cluster randomised controlled trial of vascular risk factor management in general practice.
abstract: OBJECTIVE
  To evaluate the impact of a lifestyle intervention in Australian general practice to reduce the risk of vascular disease.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ACTRN12607000423415.
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia. m.f.harris@unsw.edu.au
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Fanaian
authors.forename: Upali W
authors.initials: UW
authors.lastname: Jayasinghe
authors.forename: Megan E
authors.initials: ME
authors.lastname: Passey
authors.forename: Suzanne H
authors.initials: SH
authors.lastname: McKenzie
authors.forename: Gawaine
authors.initials: G
authors.lastname: Powell Davies
authors.forename: David M
authors.initials: DM
authors.lastname: Lyle
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Laws
authors.forename: Heike
authors.initials: H
authors.lastname: Schütze
authors.forename: Qing
authors.initials: Q
authors.lastname: Wan
mesh_terms: D000328:Adult; D005260:Female; D058006:General Practice; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012308:Risk Management; D016037:Single-Blind Method; D014652:Vascular Diseases / Q000453:epidemiology / Q000517:prevention & control*