New York: A greater percentage of people at high risk for heart disease keep up their exercise and diet programs when they get group telephone counseling, according to a study.
Everyone in the group of nearly 700 patients in the study, published in the American Journal of Cardiology, saw doctors who evaluated their health and got advice about making good lifestyle changes. But some also got group counseling sessions by phone on -- and that helped more of them stick with the suggested changes.
The message itself is nothing new -- eat more fruits and vegetables, cut back on salt, exercise more, and stop smoking.
"It's more of a question in how you can deliver it. We all know what's recommended for lifestyle change," said lead author Robert Nolan, a psychologist who studies heart disease at the University Health Network in Toronto.
"How can we deliver that in a way that's more accessible for people that really need that intervention?"
This is key given that the number of patients per doctor is growing in some areas, and some patients have trouble getting to a clinic for counseling, meaning new ways must be found to get the message out, the study said.
Ordinarily, a doctor evaluates a person's risk of heart disease by looking at factors such as weight, blood pressure, cholesterol levels, smoking status, and diabetes. Then the doctor discusses those and other factors with the patient and offers advice about what sort of lifestyle changes would be helpful.
In the study, which involved 680 patients between the ages of 35 and 74, everybody got the risk assessment and discussion. They also had blood pressure, weight and cholesterol levels taken at the start of the study and after 6 months, and told researchers how well they kept to their diet and exercise plans.
In addition, about half the participants received six telephone counseling sessions, spread over two months, on how to maintain their health. The sessions were done with small groups of four to eight people plus one counselor.
After six months, people in both groups were healthier, with improvements in their risk for heart disease. But there was a higher percentage of people in the counseled group that kept to both the diet and exercise programs, with the counseled group particularly higher in their maintenance of exercise.
Blood pressure decreased as well. The counseled group went from an average of 131/77 to 126/75 while the control group went from an average of 128/77 to about 125/76.
Nolan said that while these changes may look small, blood pressure tends to rise with age and "anything we can do to change that rate of increase is important for prevention purposes."
But Soeren Mattke, senior scientist at the RAND Health Advisory think tank in Boston, said data so far have been inconclusive.
He noted that the paper only mentioned average blood pressure and did not talk about blood pressure in individuals.
"We don't quite know how many people are up and how many are below... It's a question of who went from an unsafe value to a safe value," he added.
Both Mattke and Nolan said further studies are needed, including one that lasts for longer after the phone sessions end as well as an in-depth look at the costs.
INTERxVENT, a private company that offers phone counseling and intervention programs similar to what was used in the study, charges about $500 for a 12-month one-on-one mentored health program. David Alter, an author on the paper, is Chief Scientific Officer at INTERxVENT.
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