title: Effectiveness of a low-intensity telephone counselling intervention on an untreated metabolic syndrome detected by national population screening in Korea: a non-randomised study using regression discontinuity design.
abstract: OBJECTIVE
  Whether low-intensity telephone-counselling interventions can improve cardiometabolic risk factors in screen-detected people with metabolic syndrome (MetS) is unclear. The aim of this study was to evaluate the effectiveness of a low-intensity, telephone-counselling programme on MetS implemented by the National Health Insurance Service (NHIS) of Korea using regression discontinuity design.
  
  
  METHODS
  A nationwide non-randomised intervention study with a regression discontinuity design. A retrospective analysis using data from NHIS.
  
  
  METHODS
  NHIS, Korea from January 2011 to June 2013.
  
  
  METHODS
  5,378,558 beneficiaries with one or more MetS components by NHIS criteria detected by population screening were enrolled in the NHIS MetS Management Programme in 2012. Of these, 1,147,695 underwent annual follow-up examinations until June 2013 ('control group' which received control intervention, n=855,870; 'eligible group' which was eligible for counselling, n=291,825; 'intervention group' which participated in telephone counselling among eligible groups, n=23,968).
  
  
  METHODS
  Absolute changes in MetS components, weight and body mass index (BMI) were analysed. Multiple regression analyses were applied using the analysis of covariance model (baseline measurements as covariates).
  
  
  RESULTS
  Low-intensity telephone counselling was associated with decreased systolic BP (-0.85 mm Hg, 95% CI -1.02 to -0.68), decreased diastolic BP (-0.63 mm Hg, -95% CI -0.75 to -0.50), decreased triglyceride (-1.57 mg/dL, 95% CI -2.89 to -0.25), reduced waist circumference (-0.09 cm, 95% CI -0.16 to -0.02), reduced weight (-0.19 kg, 95% CI -0.24 to -0.15) and reduced BMI (-0.07 kg/m(2), 95% CI -0.09 to -0.05), when comparing the intervention and control groups. When individuals with low high-density lipoprotein cholesterol were analysed, the intervention was also associated with increased HDL cholesterol (0.90 mg/dL, 95% CI 0.51 to 1.29).
  
  
  CONCLUSIONS
  Low-intensity telephone counselling programmes could yield improvements in the following year on blood pressure, lipid profiles, weight and body mass index in untreated patients detected at the population screening. However, the improvements may be very modest and the clinical relevance of these small improvements may be limited.
authors.affiliation: Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Gangwon-do, Republic of Korea.
authors.forename: Sang-Wook
authors.identifier: http://orcid.org/0000-0002-6656-6205
authors.initials: SW
authors.lastname: Yi
authors.affiliation: Big Data Steering Department, National Health Insurance Service, Seoul, Republic of Korea.
authors.forename: Soon-Ae
authors.initials: SA
authors.lastname: Shin
authors.affiliation: Big Data Steering Department, National Health Insurance Service, Seoul, Republic of Korea.
authors.forename: Youn-Jung
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D001835:Body Weight; D008076:Cholesterol, HDL / Q000097:blood; D003376:Counseling / Q000379:methods*; D050171:Dyslipidemias / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000628:therapy*; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000628:therapy*; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000628:therapy*; D056910:Republic of Korea; D012189:Retrospective Studies; D013689:Telephone; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides
keywords: PUBLIC HEALTH