电话支持的心血管生活方式计划（CLIP）在一般实践患者中降低血脂和减轻体重：一项随机对照试验。
A telephone-supported cardiovascular lifestyle programme (CLIP) for lipid reduction and weight loss in general practice patients: a randomised controlled pilot trial.
机构信息
1 Discipline of General Practice, School of Population Health and Clinical Practice, The University of Adelaide, Adelaide, Australia.
2 Commonwealth Scientific and Industrial Research Organisation (CSIRO), Animal, Food and Health Sciences, PO Box 10041, Adelaide, SA 5000, Australia.
出版信息
Public Health Nutr. 2014 Mar;17(3):640-7. doi: 10.1017/S1368980013000220. Epub 2013 Mar 4.
OBJECTIVE
To evaluate a primary prevention care model using telephone support delivered through an existing health call centre to general practitioner-referred patients at risk of developing CVD, using objective measures of CVD risk reduction and weight loss.
DESIGN
Participants were randomised into two groups: (i) those receiving a telephone-supported comprehensive lifestyle intervention programme (CLIP: written structured diet and exercise advice, plus seven telephone sessions with the Heart Foundation Health Information Service); and (ii) those receiving usual care from their general practitioner (control: written general lifestyle advice). Fasting plasma lipids, blood pressure, weight, waist circumference and height were assessed on general practice premises by a practice nurse at Weeks 0 and 12.
SETTING
Two general practices in Adelaide, South Australia.
SUBJECTS
Forty-nine men and women aged 48·0 (sd 5·88) years identified by their general practitioner as being at future risk of CVD (BMI = 33·13 (sd 5·39) kg/m2; LDL cholesterol (LDL-C) = 2·66 (sd 0·92) mmol/l).
RESULTS
CLIP participants demonstrated significantly greater reductions in LDL-C (estimated mean (EM) = 1·98 (se 0·17) mmol/l) and total cholesterol (EM = 3·61 (se 0·21) mmol/l) at Week 12 when compared with the control group (EM = 3·23 (se 0·18) mmol/l and EM = 4·77 (se 0·22) mmol/l, respectively). There were no significant treatment effects for systolic blood pressure (F(1,45) = 0·28, P = 0·60), diastolic blood pressure (F(1,43) = 0·52, P = 0·47), weight (F(1,42) = 3·63, P = 0·063) or waist circumference (F(1,43) = 0·32, P = 0·577).
CONCLUSIONS
In general practice patients, delivering CLIP through an existing telephone health service is effective in achieving reductions in LDL-C and total cholesterol. While CLIP may have potential for wider implementation to support primary prevention of CVD, longer-term cost-effectiveness data are warranted.
目的
评估一种通过现有的健康呼叫中心提供电话支持的初级预防护理模式，该模式针对有发生 CVD 风险的全科医生转诊患者，使用 CVD 风险降低和体重减轻的客观指标进行评估。
设计
参与者被随机分为两组：（i）接受电话支持的综合生活方式干预计划（CLIP：书面结构化饮食和运动建议，外加与心脏基金会健康信息服务的七次电话会话）；和（ii）接受他们的全科医生的常规护理（对照组：一般生活方式建议的书面建议）。由一名实习护士在第 0 周和第 12 周在全科医生诊所评估空腹血脂、血压、体重、腰围和身高。
地点
南澳大利亚阿德莱德的两家全科诊所。
受试者
49 名年龄为 48.0（标准差 5.88）岁的男性和女性，由他们的全科医生确定为未来有 CVD 风险（BMI=33.13（标准差 5.39）kg/m2；LDL 胆固醇（LDL-C）=2.66（标准差 0.92）mmol/L）。
结果
与对照组相比，CLIP 参与者在第 12 周时 LDL-C（估计平均值（EM）=1.98（se 0.17）mmol/L）和总胆固醇（EM=3.61（se 0.21）mmol/L）的降低幅度明显更大（EM=3.23（se 0.18）mmol/L 和 EM=4.77（se 0.22）mmol/L，分别）。在收缩压（F（1,45）=0.28，P=0.60）、舒张压（F（1,43）=0.52，P=0.47）、体重（F（1,42）=3.63，P=0.063）或腰围（F（1,43）=0.32，P=0.577）方面，没有显著的治疗效果。
结论
在普通实践患者中，通过现有的电话健康服务提供 CLIP 可有效降低 LDL-C 和总胆固醇。虽然 CLIP 可能具有更广泛实施的潜力，以支持 CVD 的一级预防，但需要长期的成本效益数据。
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