Related Experiment Videos
Activating peripheral arterial disease patients to reduce cholesterol: a randomized trial
Mary M McDermott1, George Reed, Philip Greenland
1Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. mdm608@northwestern.edu
The American Journal of Medicine
|May 25, 2011
Summary
Telephone counseling helped peripheral arterial disease patients lower LDL cholesterol by encouraging them to request more intensive therapy. This intervention showed greater LDL cholesterol reduction compared to an attention control group.
Area of Science:
- Cardiovascular Medicine
- Public Health
- Behavioral Science
Background:
- Peripheral arterial disease (PAD) patients struggle to reach target low-density lipoprotein (LDL) cholesterol levels.
- This study evaluated a telephone counseling intervention to improve cholesterol management in PAD patients.
Purpose of the Study:
- To assess if a telephone counseling intervention improves LDL cholesterol levels in PAD patients.
- To compare the intervention's effectiveness against attention control and usual care.
Main Methods:
- A randomized controlled trial with 355 PAD participants (LDL cholesterol ≥70 mg/dL).
- Intervention: Patient-centered telephone counseling every 6 weeks to encourage requesting intensified cholesterol-lowering therapy.
- Control arms: Attention control (information only calls) and usual care.
Main Results:
- Intervention group showed greater LDL cholesterol reduction than attention control (-18.4 vs -6.8 mg/dL, P=.010).
- No significant difference in LDL reduction compared to usual care (-18.4 vs -11.1 mg/dL, P=.208).
- Intervention participants were more likely to initiate or increase cholesterol-lowering medication (54% vs 18% attention control, P=.001; 54% vs 31% usual care, P<.001).
Conclusions:
- Telephone counseling empowering PAD patients to request intensive therapy effectively lowers LDL cholesterol compared to information-only control.
- The intervention significantly increased medication initiation or intensification.
Related Concept Videos
01:26Atherosclerosis III: Management
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
01:27Peripheral Artery Disease III: Interprofessional Care
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
01:26Coronary Artery Disease IV: Preventive Measures
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
01:23Atherosclerosis IV: Nursing Management
Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...
01:30Peripheral Artery Disease I: Introduction
Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
01:21Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...