Efficacy of a Combined Strategy to Improve Low-density Lipoprotein Cholesterol Control Among Patients With Hypercholesterolemia: A Randomized Clinical Trial.

Autor: Párraga-Martínez I; Centro de Salud de La Roda, Gerencia de Atención Integrada de Albacete, Servicio de Salud de Castilla-La Mancha, Facultad de Medicina de Albacete, Universidad de Castilla-La Mancha, Albacete, Spain. Electronic address: iparraga@sescam.jccm.es., Escobar-Rabadán F; Centro de Salud Zona IV, Servicio de Salud de Castilla-La Mancha, Albacete, Spain., Rabanales-Sotos J; Facultad de Enfermería de Cuenca, Universidad de Castilla-La Mancha, Cuenca, Spain., Lago-Deibe F; Centro de Salud de Sárdoma, Servicio de Salud de Galicia, Vigo, Pontevedra, Spain., Téllez-Lapeira JM; Centro de Salud Zona V-B, Servicio de Salud de Castilla-La Mancha, Albacete, Spain., Villena-Ferrer A; Centro de Salud de San Clemente, Servicio de Salud de Castilla-La Mancha, San Clemente, Cuenca, Spain., Blasco-Valle M; Centro de Salud Delicias Sur, Servicio de Salud Aragón, Zaragoza, Spain., Ferreras-Amez JM; Servicio de Urgencias, Hospital Royo Villanova, Servicio Aragonés de Salud, Zaragoza, Spain., Morena-Rayo S; Centro de Salud Hellín 2, Servicio de Salud de Castilla-La Mancha, Hellín, Albacete, Spain., Del Campo-Del Campo JM; Centro de Salud de Almansa, Servicio de Salud de Castilla-La Mancha, Almansa, Albacete, Spain., Ayuso-Raya MC; Centro de Salud Zona IV, Servicio de Salud de Castilla-La Mancha, Albacete, Spain., Pérez-Pascual JJ; Centro de Salud Zona IV, Servicio de Salud de Castilla-La Mancha, Albacete, Spain.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cardiologia (English ed.) [Rev Esp Cardiol (Engl Ed)] 2018 Jan; Vol. 71 (1), pp. 33-41. Date of Electronic Publication: 2017 Jun 23.
DOI: 10.1016/j.rec.2017.05.029
Abstrakt: 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 (23.8mg/dL [95%CI, 17.5-30.1]) than in the control group (14.6mg/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<.001), but not to diet.
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.
(Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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