title: Dietitian intervention improves lipid values and saves medication costs in men with combined hyperlipidemia and a history of niacin noncompliance.
abstract: We asked if medical nutrition therapy (MNT) administered by registered dietitians could lead to beneficial clinical and financial outcomes in men with combined hyperlipidemia (hypercholesterolemia and hypertriglyceridemia). A retrospective chart review was conducted on 73 men with combined hyperlipidemia who were being considered for statin therapy because of a previous history of noncompliance with niacin therapy. Subjects participated in an 8-week dietitian intervention program as a qualifying requirement, before statin therapy. Patient records were reviewed to determine the beginning and ending serum lipid concentrations and the number and length of dietitian sessions. Complete information was available on 43 subjects, aged 60.7 +/- 10.1 years (mean +/- standard deviation). Total dietitian intervention time was 169 +/- 19 minutes in 2.7 +/- 0.6 sessions (range = 2 to 4 sessions) during 6.5 +/- 2.2 weeks of MNT (range = 4 to 8 weeks). MNT lowered levels of total cholesterol 11% (P < .001), low-density lipoprotein cholesterol 9% (P < .001), and triglycerides 22% (P < .0001) and body mass index 2% (P < .0001); MNT raised high-density lipoprotein cholesterol levels 4%. After dietitian intervention, only 15 of 30 eligible patients required antihyperlipidemic medications, which led to an annual cost savings of $27,449.10 or $638.35 per patient. A cost saving of $3.03 in statin therapy was realized for each dollar spent on MNT. We conclude that an average of 3 individualized dietitian visits of 1 hour each over an 8-week period has a beneficial effect in treating patients with combined hyperlipidemia and recommend consideration of MNT as a cost-effective intervention.
authors.affiliation: Division of Cardiology, University of California-Irvine, Orange 92868-3298, USA.
authors.forename: G
authors.initials: G
authors.lastname: Sikand
authors.forename: M L
authors.initials: ML
authors.lastname: Kashyap
authors.forename: N D
authors.initials: ND
authors.lastname: Wong
authors.forename: J C
authors.initials: JC
authors.lastname: Hsu
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000191:economics / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003362:Cost-Benefit Analysis; D004045:Dietary Services / Q000191:economics; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000178:diet therapy* / Q000188:drug therapy; D008055:Lipids / Q000097:blood*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D017035:Pravastatin / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D013997:Time Factors; D016312:Treatment Refusal; D014280:Triglycerides / Q000097:blood
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D014280:Triglycerides; D009525:Niacin; D002784:Cholesterol; D017035:Pravastatin