Thomas C. Keyserling|Stacey Sheridan|Lindy B. Draeger|Eric A. Finkelstein|Ziya Gizlice|Eliza Kruger|Larry F. Johnston|Philip D. Sloane|Carmen D. Samuel?Hodge|Kelly R. Evenson|Myron Gross|Katrina E Donahue|Michael Pignone|Maihan B. Vu|Erika A. Steinbacher|Bryan J. Weiner|Shrikant I. Bangdiwala|Alice S. Ammerman
A Comparison of Live Counseling With a Web-Based Lifestyle and Medication Intervention to Reduce Coronary Heart Disease Risk
University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|National University of Singapore|University of North Carolina at Chapel Hill|National University of Singapore|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of Minnesota|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|David H. Murdock Research Institute|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill|University of North Carolina at Chapel Hill
primary care clinicians lack skills resources offer effective lifestyle medication lm counseling reduce coronary heart disease chd risk thus effective feasible chd prevention programs needed typical practice settingsto assess effectiveness acceptability costeffectiveness combined lm intervention reduce chd risk offered counselordelivered webbased formatsa comparative effectiveness trial 5 diverse family medicine practices north carolina participants established patients aged 35 79 years known cardiovascular disease moderate high risk chd 10year framingham risk score frs 10participants randomized counselordelivered webbased format including 4 intensive 3 maintenance sessions randomization formats used webbased decision aid showing potential chd risk reduction associated lm riskreducing strategies participants chose riskreducing strategies wished followthe primary outcome withingroup change frs 4month followup measures included standardized assessments blood pressure blood lipid levels lifestyle behaviors medication adherence acceptability costeffectiveness also assessed outcomes assessed 4 12 monthsof 2274 screened patients 385 randomized 192 counselor 193 web mean age 62 years 24 african american mean frs 169 followup 4 12 months included 91 87 randomized participants respectively sustained reduction frs 4 months primary outcome 12 months counselorbased 23 95 ci 30 16 19 95 ci 28 11 respectively webbased groups 15 95 ci 22 09 17 95 ci 26 08 respectively 4 months adjusted difference frs groups 10 95 ci 18 01 p 03 12 months 06 95 ci 17 05 p 30 12month costs payer perspective 207 110 per person counselor webbased interventions respectivelyboth intervention formats reduced chd risk 12month followup web format less expensiveclinicaltrialsgov identifier nct01245686