Effectiveness of a nurse-based intervention in a community practice on patients' dietary fat intake and total serum cholesterol level

To evaluate the effect of a nurse-based intervention for patients with high total cholesterol (TC) levels in a community practice. Clinical trial without a control followed by a nonrandomized control trial. Suburban primary care practice. White patients with TC higher than 6.21 mmol/L (240 mg/dL). In the initial trial, 82 patients with a mean TC level of 6.80 mmol/L (263 mg/dL). Fifty-three preponderantly female patients in the nonrandomized control trial with a mean TC level of 6.83 mmol/L (264 mg/dL). Counseling by office nurses using the Eating Pattern Assessment Tool and handouts with brand-specific food advice. In the initial study, patients attended up to 5 nurse counseling visits. In a follow-up study, intervention patients attending 2 or more counseling sessions were matched with other patients in the practice. Eating Pattern Assessment Tool scores in the initial study and TC levels in both trials. Mean Eating Pattern Assessment Tool scores at baseline in both studies demonstrated that intervention patients were already following a diet consistent with the National Cholesterol Education Program Step I Diet. In the initial study, mean TC levels of the patients declined 2% (P < .05) and mean Eating Pattern Assessment Tool score improved from 23.4 to 20.4 (P < .001). In the follow-up study, the mean TC level of all patients improved significantly (P = .002). However, the improvement of the intervention patients was no better than that of the comparison patients. The nurse counseling intervention was not effective in patients already following a Step I Diet.