McAleer S F, Cupples M E, Neville C E, McKinley M C, Woodside J V, Tully M A
Centre for Public Health, Institute of Clinical Sciences Block B, Royal Victoria Hospital, Queen's University Belfast, Grosvenor Road, Belfast, BT12 6BA, UK.
UKCRC Centre of Excellence for Public Health Research (NI), Institute of Clinical Sciences Block B, Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 6BA, UK.
BMC Fam Pract. 2016 Jul 18;17:77. doi: 10.1186/s12875-016-0471-6.
Statin prescribing and healthy lifestyles contribute to declining cardiovascular disease mortality. Recent guidelines emphasise the importance of giving lifestyle advice in association with prescribing statins but adherence to healthy lifestyle recommendations is sub-optimal. However, little is known about any change in patients' lifestyle behaviours when starting statins or of their recall of receiving advice. This study aimed to examine patients' diet and physical activity (PA) behaviours and their recall of lifestyle advice following initiation of statin prescribing in primary care.
In 12 general practices, patients with a recent initial prescription of statin therapy, were invited to participate. Those who agreed received a food diary by post, to record food consumed over 4 consecutive days and return to the researcher. We also telephoned participants to administer brief validated questionnaires to assess typical daily diet (DINE) and PA level (Godin). Using the same methods, food diaries and questionnaires were repeated 3 months later. At both times participants were asked if they had changed their behaviour or received advice about their diet or PA.
Of 384 invited, 122 (32 %) participated; 109 (89.3 %) completed paired datasets; 50 (45.9 %) were male; their mean age was 64 years. 53.2 % (58/109) recalled receiving lifestyle advice. Of those who did, 69.0 % (40/58) reported having changed their diet or PA, compared to 31.4 % (16/51) of those who did not recall receiving advice. Initial mean daily saturated fat intake (12.9 % (SD3.5) of total energy) was higher than recommended; mean fibre intake (13.8 g/day (SD5.5)), fruit/vegetable consumption (2.7 portions/day (SD1.3)) and PA levels (Godin score 7.1 (SD13.9)) were low. Overall, although some individuals showed evidence of behaviour change, there were no significant changes in the proportions who reported high or medium fat intake (42.2 % v 49.5 %), low fibre (51.4 % v 55.0 %), or insufficient PA (80.7 % v 83.5 %) at 3-month follow-up.
Whilst approximately half of our cohort recalled receiving lifestyle advice associated with statin prescribing this did not translate into significant changes in diet or PA. Further research is needed to explore gaps between people's knowledge and behaviours and determine how best to provide advice that supports behaviour change.
他汀类药物的处方和健康的生活方式有助于降低心血管疾病死亡率。最近的指南强调了在开具他汀类药物处方时提供生活方式建议的重要性，但对健康生活方式建议的依从性并不理想。然而，对于患者在开始服用他汀类药物时生活方式行为的任何变化或他们对所接受建议的回忆情况，我们知之甚少。本研究旨在调查初级保健中开始开具他汀类药物处方后患者的饮食和身体活动（PA）行为以及他们对生活方式建议的回忆情况。
在12家全科诊所，邀请近期首次开具他汀类药物治疗处方的患者参与。同意参与的患者通过邮寄收到一份食物日记，记录连续4天摄入的食物，并返还给研究人员。我们还致电参与者，发放经过验证的简短问卷，以评估其日常典型饮食（DINE）和PA水平（戈丁问卷）。3个月后，使用相同方法重复发放食物日记和问卷。在两个时间点，均询问参与者是否改变了行为或收到了关于饮食或PA的建议。
在384名受邀者中，122人（32%）参与；109人（89.3%）完成了配对数据集；50人（45.9%）为男性；他们的平均年龄为64岁。53.2%（58/109）的人回忆起收到了生活方式建议。在那些回忆起收到建议的人中，69.0%（40/58）报告改变了饮食或PA，而在那些没有回忆起收到建议的人中，这一比例为31.4%（16/51）。初始平均每日饱和脂肪摄入量（占总能量的12.9%（标准差3.5））高于推荐值；平均纤维摄入量（13.8克/天（标准差5.5））、水果/蔬菜摄入量（2.7份/天（标准差））和PA水平（戈丁评分7.1（标准差13.9））较低。总体而言，尽管一些人表现出行为改变的迹象，但在3个月随访时，报告高脂肪或中等脂肪摄入量（42.2%对49.5%）、低纤维摄入量（51.4%对55.0%）或PA不足（80.7%对83.5%）的比例没有显著变化。
虽然我们队列中约一半的人回忆起收到了与他汀类药物处方相关的生活方式建议，但这并未转化为饮食或PA的显著变化。需要进一步研究以探索人们的知识与行为之间的差距，并确定如何最好地提供支持行为改变的建议。
