Phone counseling can help lower heart disease risk

A greater percentage of people at high risk for heart disease keep up their exercise and diet programs when they get group telephone counseling, a new study says.

Everyone in the study saw doctors who evaluated their health, and they got brief advice about making good lifestyle changes. But some of the participants also got group-counseling sessions by phone on how to maintain health - and that helped more of them stick with the changes, according to the study in the American Journal of Cardiology.

This is important because the number of patients per doctor is growing in some areas, and some patients have trouble getting to a clinic to get counseling - so health care providers need to find some new ways to deliver healthy lifestyle messages.

The message that needs to get out is familiar: eat more fruits and vegetables, don't eat so much salt, exercise more, and stop smoking.

"It's more of a question of how you can deliver it. We all know what's recommended for lifestyle change," said lead author Robert Nolan, a psychologist who studies heart disease at the University Health Network in Toronto.

But, he added, "How can we deliver that in a way that's more accessible for people that really need that intervention?"

Heart disease is the leading cause of death in the US, according to the American Heart Association. It killed more than 420,000 people in 2006 and cost $177 billion in 2010.

Other studies in the past have looked at the effectiveness of telephone counseling on maintaining heath, and especially whether it can save money, said Dr. Soeren Mattke, senior scientist at the RAND Health Advisory think tank in Boston, but the data have been inconclusive. "It's still a mixed bag if you look at the evidence," he said.

INTERxVENT, a private company that offers phone counseling and intervention programs similar to what was used in the study, charges about $500 US for a 12-month one-on-one mentored health program.

Dr. David Alter, an author on the paper, is the Chief Scientific Officer at INTERxVENT.

The researchers wanted to know whether getting extra counseling, in addition to what patients usually get, would improve health in people with a high risk of heart disease.

The usual intervention involves having the doctor evaluate a person's risk of heart disease by looking at factors like weight, blood pressure, cholesterol levels, if the person smokes, and if they have diabetes. Then the doctor discusses those and other factors with the patient and offers advice about what kinds of lifestyle changes would be helpful.

In this study, everyone got this risk assessment and discussion. About half the participants also got six phone counseling sessions, spread over two months, on how to maintain health. The sessions were done with small groups of four to eight people plus one counselor. All of the participants were between the ages of 35 and 74.