title: Benefits and costs of medical nutrition therapy by registered dietitians for patients with hypercholesterolemia. Massachusetts Dietetic Association.
abstract: The Massachusetts Dietetic Association implemented a statewide retrospective quality assurance audit to determine the effectiveness and cost of medical nutrition therapy in patients with hypercholesterolemia (> 5.20 mmol/L). Hypercholesterolemia is a major risk factor for coronary artery disease (CAD). Data were collected at 23 sites from 285 outpatients seen by a registered dietitian for a minimum of two visits. Patients taking lipid-lowering medications were excluded. Of the 285 patients, 108 (38%) were men and 177 (62%) were women. The mean age was 51.4 years (range = 22 to 79 years). Results showed that the mean reduction in serum cholesterol level was 8.6%, which translates to a decrease of approximately 17.2% in risk of CAD. Forty-five percent of the total population showed an 11% or greater reduction in serum cholesterol levels. Reduction in serum cholesterol levels correlated with increased time spent with a dietitian (r = .188, P < .001). The mean cost for nutrition intervention with a dietitian was $163 (a mean of four visits). In contrast, the estimated annual cost of treatment for patients with hypercholesterolemia using drug therapy is $1,450. A 1993 report calculated the annual cost of treating heart disease in the United States to be $80 billion. Medical nutrition therapy should be considered the initial, effective, and low-cost approach in the management of patients with mild to moderate hypercholesterolemia.
authors.affiliation: Massachusetts General Hospital, Boston, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: McGehee
authors.forename: E Q
authors.initials: EQ
authors.lastname: Johnson
authors.forename: H M
authors.initials: HM
authors.lastname: Rasmussen
authors.forename: N
authors.initials: N
authors.lastname: Sahyoun
authors.forename: M M
authors.initials: MM
authors.lastname: Lynch
authors.forename: M
authors.initials: M
authors.lastname: Carey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D004035:Diet Therapy / Q000191:economics* / Q000592:standards; D004046:Dietetics / Q000592:standards*; D005260:Female; D005521:Food Service, Hospital / Q000592:standards*; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000178:diet therapy* / Q000191:economics*; D008297:Male; D008404:Massachusetts; D008485:Medical Audit; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D000078329:Workforce
chemical_list: D002784:Cholesterol