Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol
1 Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, Spain
2 Área Básica de Salud Encants (Maragall), Institut Catala de la Salut (ICS), Barcelona, Spain
3 EAP Colmeiro, Servicio Gallego de Salud, La Coruña, Spain
4 CAP Vallcarca, CatSalut, Barcelona, Spain
5 Servicio vasco de salud-Osakidetza, Centro de Salud de Beraun, Errenteria, Spain
6 Centro de Salud Lucano, Servicio Andaluz de Salud, Córdoba, Spain
7 Centro de Salud Fuensanta, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, Spain
8 ABS Mataró 7, Institut Catala de la Salut (ICS), Barcelona, Spain
9 Centro de Salud Villarrubia-Azahara, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Córdoba, Córdoba, Spain
10 Centro de Salud "La Paz", Servicio Extremeño de Salud, Madrid, Spain
11 Distrito Sanitario Córdoba-centro, Servicio Andaluz de Salud, Córdoba, Spain
12 Hospital Regional Universitario Reina Sofía, Servicio Andaluz de Salud, Córdoba, Spain
BMC Family Practice 2011, 12:125 doi:10.1186/1471-2296-12-125Published: 5 November 2011
The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner.
An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines.
Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity.