Effectiveness of a nurse-based intervention in a community practice on patients' dietary fat intake and total serum cholesterol level
D. A. Pine, D. J. Madlon-Kay and M. Sauser
Department of Family Practice, Park Nicollet Medical Center, Minneapolis, MN, USA.
OBJECTIVE: To evaluate the effect of a nurse-based intervention for
patients with high total cholesterol (TC) levels in a community practice.
DESIGN: Clinical trial without a control followed by a nonrandomized
control trial. SETTING: Suburban primary care practice. PATIENTS: 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). INTERVENTION: 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. MAIN OUTCOME MEASURES: 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. CONCLUSION:
The nurse counseling intervention was not effective in patients already
following a Step I Diet.
