Nutritional counselling in general practice: a cost effective analysis.
OBJECTIVE
To study the clinical and cost outcomes of providing nutritional counselling to patients with one or more of the following conditions: overweight, hypertension and type 2 diabetes.


METHODS
The study was designed as a random controlled trial. Consecutive patients were screened opportunistically for one or more of the above conditions and randomly allocated to one of two intervention groups (doctor/dietitian or dietitian) or a control group. Both intervention groups received six counselling sessions over 12 months from a dietitian. However, in the doctor/dietitian group it was the doctor and not the dietitian who invited the patient to join the study and the same doctor also reviewed progress at two of the six counselling sessions.


METHODS
The study was conducted in a university group general practice set in a lower socioeconomic outer suburb of Perth, Western Australia.


METHODS
Of the 273 patients randomly allocated to a study group, 198 were women. Age ranged from 25 to 65 years. Seventy eight per cent of patients resided in the lower two socioecnomic quartiles, 56 per cent described their occupation as home duties and 78 per cent were partnered.


RESULTS
Both intervention groups reduced weight and blood pressure compared with the control group. Patients in the doctor/dietitian group were more likely to complete the 12 month programme than those in the dietitian group. Patients in the doctor/dietitian group lost an average of 6.7 kg at a cost of $A9.76 per kilogram, while the dietitian group lost 5.6 kg at a cost of $A7.30 per kilogram.


CONCLUSIONS
General practitioners, in conjunction with a dietitian, can produce significant weight and blood pressure improvement by health promotion methods.
Department of General Practice, University of Western Australia.
D A
DA
Pritchard
J
J
Hyndman
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F
Taba
D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy*; D015444:Exercise; D005194:Family Practice; D005260:Female; D006293:Health Promotion; D006801:Humans; D006973:Hypertension / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D009765:Obesity / Q000178:diet therapy*; D010352:Patient Dropouts; D010353:Patient Education as Topic / Q000191:economics*; D012923:Social Class; D014904:Western Australia