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.

CONCLUSION:

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: Mary M McDermott, George Reed, Philip Greenland, Kathy M Mazor, Sherry Pagoto, Judith K Ockene, Rex Graff, Philip A Merriam, Kathy Leung, Larry Manheim, Melina R Kibbe, Barbara Olendzki, William H Pearce, Ira S Ockene
• Journal: The American journal of medicine (Am J Med) Vol. 124 Issue 6 Pg. 557-65 (Jun 2011) ISSN: 1555-7162 [Electronic] United States
• PMID: 21605733 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Anticholesteremic Agents
• Cholesterol, LDL
• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Adult
• Aged
• Anticholesteremic Agents (therapeutic use)
• Cholesterol, LDL (blood)
• Counseling
• Female
• Follow-Up Studies
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Hypercholesterolemia (blood, drug therapy)
• Male
• Middle Aged
• Peripheral Arterial Disease (blood, drug therapy)
• Telephone
• Time Factors
• Treatment Outcome