Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol

Abstract

BackgroundThe 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.Methods/DesignAn 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.DiscussionMotivational 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.Trials RegistrationClinicalTrials.gov (NCT01282190).

Evaluating the integration of chronic disease prevention and management services into primary health care

“…Among ongoing studies, Perula et al published a study protocol of an open, two-arm parallel, non-pharmacological approach based on the promotion of a healthy diet and physical activity to control cholesterol levels among patients with hyperlipidemia in the context of primary care [44]. The intervention is based either on motivational interviewing or on the usual brief advice.…”

Is the Scale for Measuring Motivational Interviewing Skills a valid and reliable instrument for measuring the primary care professionals motivational skills?: EVEM study protocol

“…A total of 50 GPs from 50 offices at 32 primary care centers of the Spanish National Health System are participating in the Dislip-EM study [19]. The following subpopulations are being studied:…”

“…Figure 1 shows the study protocol design. This study approaches the complementary objective of the Dislip-EM project, a cluster randomized, controlled clinical trial designed to assess the effectiveness of Motivational Interviewing in reducing cardiovascular risk and improving lipid control in patients with hyperlipidemia [19]. …”

Measuring the quality of motivational interviewing in primary health care encounters: The development and validation of the motivational interviewing assessment scale (MIAS)

“…Differences in sample sizes between the original protocol and the validation process were due to feasibility criteria and losses in the development of the Dislip-EM study. [12,13] The Dislip-EM study was a multi-centric randomized control trial conducted in Spain where MI was used in the intervention group to help patients reduce their cardiovascular risk.…”