A telephone-supported cardiovascular lifestyle programme (CLIP) for lipid reduction and weight loss in general practice patients: a randomised controlled pilot trial

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/m(2); 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.