The costs and effects of two different lipid intervention programmes in primary health care.
OBJECTIVE
To compare the costs and effects of two different intervention strategies for the nonpharmacological treatment of hypercholesterolaemia.


METHODS
Randomized, controlled trial. Subjects were randomly allocated to one of two intervention models and followed up for 1 year.


METHODS
Vårby Health Centre, a primary care practice located in a suburb of Stockholm.


METHODS
Subjects with a total serum cholesterol in the range 7.0-7.8 mmol L-1 and no signs of ischaemic heart disease or diabetes mellitus, randomized to a low-intensity (n = 35) or medium-intensity (n = 41) intervention.


METHODS
Two strategies were used, one labelled medium-intensity strategy which followed national current guidelines for nonpharmacological treatment of hypercholesterolaemia, the other was a low-intensity strategy.


METHODS
Total serum cholesterol and intervention costs.


RESULTS
Both intervention strategies resulted in small (mean 3.5%) decreases in total cholesterol with no significant difference between the groups. The cost per subject in the low-intensity group was SEK 753 and in the medium-intensity group SEK 3614.


CONCLUSIONS
Because the effect of the two intervention programmes did not differ, the low-intensity programme is to be preferred from a cost-effectiveness point of view. If only one-third of the population in Stockholm county with cholesterol levels > or = 6.5 mmol L-1 are discovered by the primary health care system, and follow the treatment advice, the net savings in the low-intensity model compared to the current guidelines here presented as the moderate-intensity model, would be SEK 93 million.
Tomson
Y
Y
Department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Stockholm, Sweden.
Johannesson
M
M
Aberg
H
H
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002784:Cholesterol / Q000097:blood; D003362:Cost-Benefit Analysis; D004046:Dietetics / Q000191:economics; D005194:Family Practice / Q000191:economics; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000191:economics* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000191:economics; D011320:Primary Health Care / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics; D013548:Sweden; D016896:Treatment Outcome
D002784:Cholesterol