Economic impact and quality of life as endpoints of nutritional therapy.
OBJECTIVE
The present review exposes why considering primary endpoints such as cost-effectiveness and quality of life in wasting disease research is critical for promoting medical nutrition therapy.


RESULTS
Despite growing evidence that nutritional support improves patients' clinical outcome, its use is not widely considered as a routine by most healthcare professionals. Many factors, depending on physicians, patients and institutions, could explain such a resistance to implement nutritional therapy in routine care. One of these factors is the lack of indisputable evidence that nutritional intervention improves patients' quality of life and is cost-effective.


CONCLUSIONS
In today's resource-constrained environment, disease management strategies are judged in terms of not only clinical efficacy and safety but also patient satisfaction and economic dimensions. The demonstration of a positive costs/saving ratio is crucial to obtain the political backing of health administrators and sustain further investment in research. Moreover, improving patients' quality of life promotes their capacity to cope with psychological distress, increases their tolerance and response to treatments, and enhances the global image of the healthcare system. In wasting diseases research, there is a need for well designed clinical trials from which cost-utility performance of nutritional interventions could be assessed in order to convince all the stakeholders and to get support from clinicians and patients themselves.
Department of Clinical Nutrition, Geneva University Hospital, Geneva, Switzerland.
Patrice
P
Darmon
Herbert
H
Lochs
Claude
C
Pichard
D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D006801:Humans; D044623:Nutrition Therapy / Q000191:economics* / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D016896:Treatment Outcome; D019282:Wasting Syndrome / Q000628:therapy*