Effectiveness of motivational interviewing in patients with dyslipidemia: a randomized cluster trial

BMC Family Practice

Research Article

Manuel Campiñez-Navarro¹  Remedios Martín-Álvarez¹  Nieves Barragán-Brun¹  Jesús Manuel Novo-Rodríguez²  Jose Angel Fernández-García³  Margarita Criado-Larumbe³  Juan Carlos Arbonies-Ortiz⁴  Julia Bóveda-Fontán⁵  Josep M. Bosch-Fontcuberta⁶  Enrique Martín-Rioboó⁷  Luís Ángel Pérula-de Torres⁸ 

[1] CAP Vallcarca, Barcelona, Spain;Centro de Saúde A Milagrosa, Lugo, Spain;Health Center Villarrubia (UGC Occidente), Teaching Unit of Family and Community Medicine Cordoba. Sanitary District Cordoba and Guadalquivir. Maimonides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofía University Hospital/University of Córdoba, Córdoba, Spain;Helth Center Errentería, Avda. Galzaraborda 67, Donostia, Spain;Primary Care Center Colmeiro, Vigo, Spain;Primary Care Center Encants (Maragall), Barcelona, Spain;UGC Fuensanta. Teaching Unit of Family and Community Medicine Cordoba. Maimónides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofía University Hospital/University of Cordoba, Córdoba, Spain;Unidad Docente de Medicina Familiar y Comunitaria de Córdoba. Distrito Sanitario Córdoba y Guadalquivir. C/Isla de Lanzarote, Córdoba, Spain;Maimónides Institute for Biomedical Research of Cordoba (IMIBIC)/Reina Sofia University Hospital/University of Córdoba, Córdoba, Spain;

关键词: Motivational interviewing;    Behavior change counselling;    Lifestyle change;    Dyslipidemia;    Cardiovascular risk factors;   

DOI  :  10.1186/s12875-015-0370-2

 received in 2015-01-26, accepted in 2015-10-13,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIt is known that making people change their habits is challenging. It is crucial to identify the most effective approach that general practitioners (GPs) should use to help their patients change unhealthy habits. The objective this study was to assess the efficacy of a multifactorial intervention based on Motivational Interviewing performed by general practitioners to enhance lipid levels in patients with dyslipidemia, as compared to standard care.MethodsA multicenter, controlled, randomized, cluster, two-parallel arm trial with a 12-month follow-up conducted in 25 community health centers of the Spanish. 38 GPs and 227 primary care patients with uncontrolled dyslipidemia were included in the trial. GPs performed an intervention based either on Motivational Interviewing (MI) or standard practice. Lipid levels were measured, and the control degree was analyzed based on the criteria of clinical guidelines.Results107 were assigned to the Experimental Group (EG) and 120 to the Control Group (CG). An overall improvement was achieved in total cholesterol levels (Mean Difference –MD- = −19.60; 95 % CI: −15.33 at −23.87 mg/dl; p < 0.001), LDL-cholesterol levels (MD = −13.78; 95 % CI: −9.77 at −17.79 mg/dl; p < 0.001) and triglycerides (MD = −19.14; CI 95 %: −11.29 at −26.99 mg/dl; p < 0.001). No differences were found between the two groups. However, when we assessed the degree of lipid control by combining cholesterol <200 mg/dl and LDL-cholesterol < 130 mg/dl parameters, it was observed that a higher percentage of patients achieved target figures in the EG versus CG (13.1 % vs. 5.0 %; adjusted OR = 5.77, 95 % CI: 1.67-19.91).ConclusionA Motivational Interviewing-based approach conducted by Primary Care physicians aimed at patients with dyslipidemia, achieved a significant reduction in all lipid parameters, cardiovascular risk, weight reduction and the adherence to the Mediterranean diet, similar to that obtained with the usual intervention and superior in the proportion of patients achieving combined lipid control goals and the level of physical exercise.Trial registrationthe trial is registered in ClinicalTrials.gov (NCT01282190; January 21, 2011).

【 授权许可】

CC BY   
© Bóveda-Fontán et al. 2015