1. Efficacy of a Combined Strategy to Improve Low-density Lipoprotein Cholesterol Control Among Patients With Hypercholesterolemia: A Randomized Clinical Trial
- Author
-
M. Candelaria Ayuso-Raya, Ignacio Párraga-Martínez, José M. Ferreras-Amez, Susana Morena-Rayo, Francisco Escobar-Rabadán, Juan M. Téllez-Lapeira, José M. del Campo-del Campo, José J. Pérez-Pascual, Mariano Blasco-Valle, Alejandro Villena-Ferrer, Fernando Lago-Deibe, and Joseba Rabanales-Sotos
- Subjects
Male ,medicine.medical_specialty ,Hypercholesterolemia ,Psychological intervention ,Low density lipoprotein cholesterol ,030204 cardiovascular system & hematology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Randomized controlled trial ,law ,Internal medicine ,Intervention (counseling) ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Dose-Response Relationship, Drug ,business.industry ,Incidence ,Cholesterol, LDL ,General Medicine ,Middle Aged ,medicine.disease ,Clinical trial ,Treatment Outcome ,Spain ,Practice Guidelines as Topic ,Physical therapy ,Female ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Dyslipidemia ,Follow-Up Studies - Abstract
Introduction and objectives Several interventions can improve low-density lipoprotein cholesterol (LDL-C) control. Our main objective was to evaluate the efficacy of a combined intervention to improve LDL-C control in patients with hypercholesterolemia. The study also assessed the efficacy of the intervention in improving adherence (pharmacological, diet, and exercise). Methods A multicenter, parallel group, randomized clinical trial (primary care) was conducted in 358 adults diagnosed with hypercholesterolemia, whether receiving prior drug therapy or not. We compared 178 participants who received the combined intervention (written material, self-completed registration cards, and messages to mobile telephones) with 178 controls. The main outcome variable was the proportion of participants with adequate LDL-C control (target levels of the European guidelines on dyslipidemia and cardiovascular risk) at 24 months. Results At 24 months, the mean reduction in LDL-C was significantly higher in the intervention group (23.8 mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6 mg/dL [95%CI, 8.9-20.4]; P = .034). The mean LDL-C decrease was 13.1% ± 28.6%. At 1 year, the proportion of participants with adequate control was significantly higher in the intervention group than in the control group (43.7% vs 30.1%; P = .011; RR, 1.46). Adherence was significantly higher in the intervention group, both to drug therapy (77.2% vs 64.1%; P = .029) and exercise (64.9% vs 35.8; P Conclusions The combined intervention significantly reduced LDL-C (by more than 13% at 2 years) and improved the degree of LDL-C control in patients with hypercholesterolemia at 1 year.
- Published
- 2018
- Full Text
- View/download PDF