Evidence map›Paper›PMID 40671037›Full record

Trial reportBMC health services research2025

The effectiveness of medical nutrition therapy for people at moderate to high risk of cardiovascular disease in an Australian rural primary care setting: 12-month results from a pragmatic cluster randomised controlled trial.

Tracy L Schumacher, Anna Jansson, Jaimee Herbert, Erin D Clarke, Carissa Alderton, Penny Milson, Christopher Oldmeadow, Leanne J Brown, Megan E Rollo, Annabelle Williams and 7 more

Abstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Tracy L SchumacherDepartment of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW, 2340, Australia.ORCID http://orcid.org/0000-0002-3541-6036
Anna JanssonFood and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.ORCID http://orcid.org/0000-0001-9039-2033
Jaimee HerbertDepartment of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW, 2340, Australia.ORCID http://orcid.org/0000-0002-4757-8905
Erin D ClarkeFood and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.ORCID http://orcid.org/0000-0001-8250-5990
Carissa AldertonDepartment of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW, 2340, Australia.ORCID http://orcid.org/0000-0002-2975-5744
Penny MilsonDepartment of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW, 2340, Australia.ORCID http://orcid.org/0000-0003-4078-7437
Christopher OldmeadowData Sciences, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.ORCID http://orcid.org/0000-0001-6104-1322
Leanne J BrownDepartment of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW, 2340, Australia.ORCID http://orcid.org/0000-0002-4340-2320
Megan E RolloSchool of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, 6102, Australia.ORCID http://orcid.org/0000-0003-1303-2063
Annabelle WilliamsHunter New England Central Coast Primary Health Network, Tamworth, 2340, Australia.ORCID http://orcid.org/0000-0002-3601-8056
M Com NutrHunter New England Central Coast Primary Health Network, Tamworth, 2340, Australia.
Michelle GuppySchool of Rural Medicine, University of New England, Armidale, NSW, 2350, Australia.ORCID http://orcid.org/0000-0001-7256-4938
Andrew BoyleSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.ORCID http://orcid.org/0000-0002-3919-5269
Shanthi RamanathanSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.ORCID http://orcid.org/0000-0003-1374-5565
Jennifer MayDepartment of Rural Health, College of Health Medicine and Wellbeing, University of Newcastle, Tamworth, NSW, 2340, Australia.ORCID http://orcid.org/0000-0002-3728-4313
John AttiaSchool of Medicine and Public Health, College of Health Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.ORCID http://orcid.org/0000-0001-9800-1308
Clare E CollinsFood and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia. clare.collins@newcastle.edu.au.ORCID http://orcid.org/0000-0003-3298-756X

Funding

Medical Research Futures Fund, Australia APP1200481National Health and Medical Research Council L3 APP2009340
6 · The paper itself

Abstract

purposeTo reduce risk of cardiovascular disease (CVD) in adults, as assessed by primary care doctors in rural NSW, Australia. Medical nutrition therapy (MNT) was delivered by Accredited Practicing Dietitians (APDs) using telehealth.

methodsThe study was a 12-month pragmatic cluster randomised controlled trial. All primary care practices (PCPs) within a large rural region were invited to participate, with enrolled practices stratified based on rurality and practice size. Patients at moderate to high CVD risk were recruited via practices. Usual care (UC) was provided by the patient's general practitioner (GP). In addition to UC, the intervention group received two hours of MNT telehealth (video calls) consultations from an APD during five sessions over 6 months. The primary outcome was total serum cholesterol. Secondary outcomes included LDL cholesterol, triglycerides, blood glucose control, blood pressure, weight and waist circumference. Changes were analysed using Bayesian linear mixed models and posterior probability.

findingsSixteen PCPs recruited 132 eligible participants (n = 91 intervention, n = 41 UC), with 79% (72/91) and 80% (33/41) respectively completing a primary or secondary outcome. No significant differences were found between groups for total cholesterol, LDL cholesterol or blood pressure at 12-months. However, the intervention group had significant improvements in blood glucose control (HbA1c: -0.16%, 95%CI: -0.32, -0.01) and decreased body weight (-2.46 kg, 95%CI: -4.54, -0.41) compared to UC at 12-months.

conclusionsResults indicate that two hours of MNT delivered by an APD via telehealth is a synergistic adjunct therapy to support the usual care provided by GP, with benefits continuing to 12-months.

Indexed as

Cardiovascular DiseasesNutrition TherapyPrimary Health CareRural Health ServicesAdultAgedCholesterolFemaleHumansMaleMiddle AgedNew South WalesRural PopulationTelemedicineCholesterolCardiovascular diseaseDietitianMedical nutrition therapyPrimary health careRural healthTelehealth

Identifiers

PMID40671037
PMCPMC12269237

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.