Effectiveness of a Nurse-Based Intervention in a Community Practice on Patients' Dietary Fat Intake and Total Serum Cholesterol Level
Donald A. Pine, MD;
Diane J. Madlon-Kay, MD;
Mary Sauser, RN
Arch Fam Med. 1997;6(2):129-134.
Abstract
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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). Fiftythree 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 brandspecific 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.
Author Affiliations
From the Department of Family Practice, Park Nicollet Medical Center, Minneapolis (Dr Pine and Ms Sauser), and the Department of Family and Community Medicine, St Paul Ramsey Medical Center, St Paul (Dr Madlon-Kay), Minn.
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