Can multiple lifestyle behaviours be improved in people with familial hypercholesterolemia? Results of a parallel randomised controlled trial

PLoS One. 2012;7(12):e50032. doi: 10.1371/journal.pone.0050032. Epub 2012 Dec 12.

Abstract

Objective: To evaluate the efficacy of an individualised tailored lifestyle intervention on physical activity, dietary intake, smoking and compliance to statin therapy in people with Familial Hypercholesterolemia (FH).

Methods: Adults with FH (n = 340) were randomly assigned to a usual care control group or an intervention group. The intervention consisted of web-based tailored lifestyle advice and face-to-face counselling. Physical activity, fat, fruit and vegetable intake, smoking and compliance to statin therapy were self-reported at baseline and after 12 months. Regression analyses were conducted to examine between-group differences. Intervention reach, dose and fidelity were assessed.

Results: In both groups, non-significant improvements in all lifestyle behaviours were found. Post-hoc analyses showed a significant decrease in saturated fat intake among women in the intervention group (β = -1.03; CI -1.98/-0.03). In the intervention group, 95% received a log on account, of which 49% logged on and completed one module. Nearly all participants received face-to-face counselling and on average, 4.2 telephone booster calls. Intervention fidelity was low.

Conclusions: Individually tailored feedback is not superior to no intervention regarding changes in multiple lifestyle behaviours in people with FH. A higher received dose of computer-tailored interventions should be achieved by uplifting the website and reducing the burden of screening questionnaires. Counsellor training should be more extensive.

Trial registration: Dutch Trial Register NTR1899.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Counseling
  • Diet / psychology*
  • Exercise / psychology*
  • Female
  • Fruit
  • Health Behavior*
  • Health Promotion / methods
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hyperlipoproteinemia Type II / drug therapy
  • Hyperlipoproteinemia Type II / psychology*
  • Life Style*
  • Male
  • Medication Adherence / psychology*
  • Middle Aged
  • Surveys and Questionnaires
  • Treatment Outcome
  • Vegetables

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Grants and funding

This project was financed by ZonMw (Netherlands Organisation for Health, Research and Development). The publication of the manuscript was funded by The Netherlands Organization of Scientific Research. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.