Effect of a motivational intervention of obesity upon cardiovascular risk factors.

Authors

  • Mª Loreto Tárraga Marcos Enfermera Residencia Geriátrica Los Álamos de Albacete.
  • Josefa María Panisello Royo Medicina Interna Igualada (Barcelona).
  • Nuria Rosich Psicología Barcelona.
  • Juan Solera Albero Medico Familia Albacete.
  • Angel Celada Rodriguez Profesor Asociado Medicina Universidad Castilla la Mancha.
  • Raul Salmerón Medico Familia Albacete.
  • Pedro J. Tárraga López Profesor Asociado Medicina Universidad Castilla la Mancha.

DOI:

https://doi.org/10.19230/jonnpr.2016.1.2.974

Keywords:

Blood glucose, Cholesterol, Blood pressure, Motivational intervention.

Abstract

Objective: To determine the effect on cardiovascular risk factors in a group of motivational intervention by nurses trained by an expert
psychologist, complementarily to the usual procedure.
Methods: Multicenter intervention in overweight and obese patients randomized clinical trial. Randomization of intervention by Basic
Health Zones (ZBS).Two groups located in separated different centers, one receiving motivational intervention in group (study group)
and the other routine monitoring (control group) were established. Variables: Sociodemographic, results: percentage of patients
reducing 5% of weight, assessment of cardiovascular risk factors and analytical data.
Results: 696 patients were evaluated; 377 control and 319 of the study group. Weight diminished in both groups in each visit. Mean
percent weight reduction remained at 1% in the control group and 2.5% in the intervention group (p-value = 0.009). 55.8% of patients
reduced their weight in the control group and 65.5% in the study group (p-value = 0.0391). 18.1% of patients in the control group
reduced more than 5% of weight; this percentage increased to 26.9% in the intervention group being statistically significant (p-value = 0.0304). No significant differences (5% vs. 8%) were detected at 2 years in the case of the 10% target. It was found after two years that BMI was reduced an average 0.9 kg / m2 in the control group and 2.4 kg / m2 in the study group (p-value = 0.0237). A significant evolution in triglycerides reduction and systolic blood pressure was detected. However there was no statistically significant reduction in blood sugar, diastolic blood pressure and other lipid parameters (total cholesterol, HDL and LDL-cholesterol).

Downloads

Download data is not yet available.

References

Obesity: preventing and managing the global epidemic. Report of a WHO consultation. Technical report series n.º

Geneva WHO, 2000.

NIH. National Institutes of Health. National Heart, Lung and Blood Institute. Clinical Guidelines on the

identification, evaluation and treatment of overweight and obesity in adults. The evidence report. Bethesda, 1999.

Sahuquillo Martínez A, Solera Albero J, Rodríguez Montes JA, Celada Rodríguez A, Tárraga Marcos ML, Torres

Moreno P, Tárraga López PJ. Alteración de los parámetros hepáticos en la esteatosis hepática no alcohólica de

pacientes con síndrome metabólico. JONNPR. 2016;1(1):19-24. DOI: 10.19230/jonnpr.2016.1.1.929

Bonow R, and Eckel R. Diet, obesity, and cardiovascular risk. N. Engl. J. Med,May 22,2003 348;21

Ridker P, Stampfer M, and Rifai N. Novel Risk factors for syhstemic atherosclerosis. A comparison of ©-reactive

protein, fibrinogen, homocysteine, lipoprotein (a), and standard cholester screenin as predictors of peripheral

arterial disease. JAMA, may 16, 2001-vol. 285

Cañizo F.J., Aguilar M, Carral F., Conget I., Costa A, Esteve E. Et al. Diabetes Mellitus tipo 2 y factores de riesgo

cardiovascular. Nilo industria gráfica S.A. 2003. Pag. 103-104.

Dotevall A., Johansson S, and Wilhelmsen L. Association between fibrinogen and other risk faactors for

cardiovascular disease in men and women. AEP . September 1994; vol 4: 369-374

Peeters A, Barendregt JJ, Willekens F, Mackenbach JP, Al Mamun A, Bonneux L, . Obesity in adulthood and its

consequences for life expectancy: A life-table analysis Ann Intern Med 2003;138:24-32.

ARANCETA J, ET AL. DOCUMENTO DE CONSENSO: OBESIDAD Y RIESGO CARDIOVASCULAR Clin Invest

Arterioscl 2003;15(5):196-233

Gutiérrez-Fisac JL, Banegas Banegas JR, Rodríguez Artalejo F, Regidor. E. Increasing prevalence of overweight

and obesity among Spanish adults, 1987-1997. Int J Obesity 2000;24:1677-82.

Vázquez R., López J. Mª. Obesidad. La epidemia del siglo XXI. Rev Esp Econ Salud 2002; 1, (3): 34-42.

Consenso SEEDO’2000 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de

intervención terapéutica MEDICINA CLÍNICA. VOL. 115. NÚM. 15. 2000

Brownell KD, ed. The LEARN program for weight control.7th ed. Dallas: American Health Publishing, 1998.

Brownell KD, Rodin J. The weight maintenance survival guide. Dallas:Brownell&Hager, 1990

Gortmaker SL, Must A, Perrin JM. Social and economic consequences of overweigh in adolescence and young

adulthood. New Engl J Med 1993;329:1008-12.

Barr SI, Yarker KV, Levy-Milne R, Chapman GE.Canadian dietitians' views and practices regarding obesity and

weight management. J Hum Nutr Diet. 2004 Dec;17(6):503-12.

Steptoe A, Kerry S, Rink E, Hilton S. The impact of behavioral counseling on stage of change in fat intake,

physical activity, and cigarette smoking in adults at increased risk of coronary heart disease. Am. J. Public Health.

Feb;91 (2):265-9.

Thomas A., Robert I. , Leslie G. , David B. ,Suzanne P., Robert K. , et al.. Randomized Trial of Lifestyle

Modification and Pharmacotherapy for Obesity. N. engl j med 2005; 353:2111-20.

Shaw K, O'Rourke P, Del Mar C, Kenardy J. Intervenciones psicológicas para el sobrepeso o la obesidad

(Revisión Cochrane). http://www.update-software.com. The Cochrane Library, 2005 Issue 4. ;

Duenas Herrero RM, Aleu Bover M, Gonzalez Tejon I, San Molina L, Salavert Jimenez J, Arranz Marti B. Impact

of medical counseling to quit smoking during the process of dehabituation in patients with mental illness. Actas

Esp Psiquiatr. 2004 Sep-Oct;32(5):287-92.

Wakefield M, Olver I, Whitford H, Rosenfeld E. Motivational interviewing as a smoking cessation intervention for

patients with cancer: randomized controlled trial. Nurs Res. 2004 Nov-Dec;53(6):396-405

McCambridge J, Strang J.The efficacy of single-session motivational interviewing in reducing drug consumption

and perceptions of drug-related risk and harm among young people: results from a multi-site cluster randomized

trial. Addiction.2004.Jan;99(1):39-52.

Burke BL, Arkowitz H, Menchola M.The efficacy of motivational interviewing: a meta-analysis of controlled clinical

trials. J Consult Clin Psychol. 2003 Oct;71(5):843-61

Lugoboni F, Quaglio G, Mezzelani P, Pajusco B, Casari R, Lechi A Improving compliance in internal medicine:

the motivational discussion. Ann Ital Med Int. 2004 Jul-Sep;19(3):155-62. (24). BION, W.R.: Experiencias en

grupos. Ed. Piadós. Barcelona, 1.985.

Burke BL, Arkowitz H, Menchola M.The efficacy of motivational interviewing: a meta-analysis of controlled clinical

trials. J Consult Clin Psychol 2003; 71:843-61.

Lugoboni F, Quaglio G, Mezzelani P, Pajusco B, Casari R, Lechi A Improving compliance in internal medicine:

the motivational discussion. Ann Ital Med Int 2004; 19:155-62.

Bion, W.R.: Experiencias en grupos. Ed. Piadós. Barcelona, 1.985.

Arrebola Vivas, E. et al. Eficacia de un programa para el tratamiento del sobrepeso y la obesidad no mórbida en

atención primaria y su influencia en la modificación de estilos de vida. Nutr Hosp 2013;28:37-141.

Doyle M, Siegel R, Supe K. Stages of change and transitioning for adolescent patients with obesity and

hypertension. Adv Chronic Kidney Dis 2006; 13:386-93.

Prochaska JO, Velicer WF, Rossi JS, Goldstein MG, Marcus BH, Rakowski Wet al. Stages of change and

decisional balance for 12 problems behaviors. Health Psichology 1994; 13: 39-46.

Formiguera i Sala X., Moreno Esteban y el grupo de investigadores del Estudio OBESO. Rev Esp Obesidad

; Supl. Nº 1. Pag: 10-19.

Machin D, Campbell MJ,Fayers P, Pinol A. Sample Size Tables for Clinical Studies. 2nd edition. Oxford.

Blackwell Science, 1997.

Alonso J, Regidor E, Barrio G, Prieto L, Rodríguez C, de la Fuente L. Valores poblacionales de referencia de la

versión española del Cuestionario de Salud SF-36. Med Clin 1998; 111:410-416.

Burke BS.R. The diet history as atool in research. J. Am. Tiet Assoc 1947; 23: 1041-14611.

Omar RZ, Thompson SG. Analysis of a cluster randomized trial with binary outcome data using a multilevel

model. Stat Med 2000; 19 2675-88.

Published

2016-06-15