Is the process of delivery of an individually tailored lifestyle intervention associated with improvements in LDL cholesterol and multiple lifestyle behaviours in people with Familial Hypercholesterolemia?

Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that markedly elevates plasma low-density lipoprotein (LDL) cholesterol and causes premature coronary heart disease. There are at least 20 million people with FH worldwide, but the majority remains undetected and current treatment is often suboptimal. To address this major gap in coronary prevention we present, from an international perspective, consensus-based guidance on the care of FH. The guidance was generated from seminars and workshops held at an international symposium. The recommendations focus on the detection, diagnosis, assessment and management of FH in adults and children, and set guidelines for clinical purposes. They also refer to best practice for cascade screening and risk notifying and testing families for FH, including use of genetic testing. Guidance on treatment is based on risk stratification, management of non-cholesterol risk factors and safe and effective use of LDL lowering therapies. Recommendations are given on lipoprotein apheresis. The use of emerging therapies for FH is also foreshadowed. This international guidance acknowledges evidence gaps, but aims to make the best use of contemporary practice and technology to achieve the best outcomes for the care of FH. It should accordingly be employed to inform clinical judgment and be adjusted for country-specific and local healthcare needs and resources.

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“…All patients with FH should be counselled on lifestyle modifications [6][7][8][9][10][11][12][13][14]99].…”

Section: Modification Of Lifestyle and Non-cholesterol Risk Factorsmentioning

confidence: 99%

“…Dietetic services are highly desirable [8,[99][100][101]. Advice from health and adolescent psychologists [46,82,201] and exercise physiologists [102] may be required.…”

Section: Organization and Development Of Carementioning

confidence: 99%

Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation

Watts

Gidding²,

Wierzbicki

et al. 2014

Eur J Prev Cardiolog

143

204

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“…In one study, the MITI results of two practitioners were weighed based on the number of participants each practitioner had counseled to obtain an overall MI fidelity for the study intervention [26]. In the study of Ang et al (2013), the results for individual MITI variables were not reported, but the proportion of audio-recorded sessions that reached the recommended threshold for Beginning Proficiency (in all MITI variables) was reported for both the MI and the control condition [24].…”

Section: Reporting Miti Resultsmentioning

confidence: 99%

“…[24] (25%); [25] (16%); [26] (11%); [27] (28%); [28] (25%); [29] (23%); [30] (32%)). However, the study of Smith et al (2012) is an exception to this since 100% of recorded sessions were assessed, although the total number of sessions in this study only comprised 38 [31].…”

Section: Selection Of Samples For Assessmentmentioning

confidence: 99%

“…However, the study of Smith et al (2012) is an exception to this since 100% of recorded sessions were assessed, although the total number of sessions in this study only comprised 38 [31]. In studies where the intervention was delivered by more than one practitioner, 10-17 sessions per practitioner were selected for assessment ([32], (n = 17); [26] (n = 10)) to represent a reliable overview of the quality of the individual practitioner throughout the study period. El-Mallakh et al (2012) Some studies require a comparison of overall group results (average of multiple practitioners), for example, when usual care conditions containing an attention control intervention without an MI component and an MI intervention condition are compared (e.g.…”

Section: Selection Of Samples For Assessmentmentioning

confidence: 99%

See 1 more Smart Citation

How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations

Jelsma

Mertens

Forsberg

et al. 2015

Contemporary Clinical Trials

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Many randomized controlled trials in which motivational interviewing (MI) is a key intervention make no provision for the assessment of treatment fidelity. This methodological shortcoming makes it impossible to distinguish between high-and low-quality MI interventions, and, consequently, to know whether MI provision has contributed to any intervention effects. This article makes some practical recommendations for the collection, selection, coding and reporting of MI fidelity data, as measured using the Motivational Interviewing Treatment Integrity Code. We hope that researchers will consider these recommendations and include MI fidelity measures in future studies.

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Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors

Patnode

Evans

Senger

et al. 2017

JAMA

322

196

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Diet and physical activity behavioral interventions for adults not at high risk for cardiovascular disease result in consistent modest benefits across a variety of important intermediate health outcomes across 6 to 12 months, including blood pressure, low-density lipoprotein and total cholesterol levels, and adiposity, with evidence of a dose-response effect, with higher-intensity interventions conferring greater improvements. There is very limited evidence on longer-term intermediate and health outcomes or on harmful effects of these interventions.

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Is the process of delivery of an individually tailored lifestyle intervention associated with improvements in LDL cholesterol and multiple lifestyle behaviours in people with Familial Hypercholesterolemia?

Cited by 23 publications

References 50 publications

Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation

Integrated guidance on the care of familial hypercholesterolaemia from the International FH Foundation

How to Measure Motivational Interviewing Fidelity in Randomized Controlled Trials: Practical Recommendations

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for Cardiovascular Disease Prevention in Adults Without Known Cardiovascular Disease Risk Factors

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