Medical nutrition therapy for hyperlipidemia management is widely recommended by clinical guidelines. Is it cost-effective?
In 2015, the National Lipid Association published evidenced-based recommendations that support medical nutrition therapy (MNT) provided by a registered dietitian nutritionist to help manage dyslipidemia-- recommendations strongly affirmed by other national organizations.
There is significant resistance at the payor level, however, to reimbursement for the service. Geeta Sikand, MA, RD, of the University of California Irvine and colleagues performed a meta-analysis, published recently in the Journal of Clinical Lipidology, to assess the clinical and cost benefits of the intervention. Click through the short slide show above for highlights of the results.
Medical Nutrition Therapy for Dyslipidemia. Multiple guidelines recommend referral to RDN for MNT for managing cardiometabolic risk, including hypertension, overweight/obesity, metabolic syndrome, prediabetes, and diabetes. Organizations in support of this step include the American Heart Association, the American College of Cardiology, the Obesity Society, and the American Diabetes Association.
Meta-analysis of MNT: Clinical Impact, Costs? Conducted by the Academy of Nutrition and Dietetics; searched databases from 2003-2014 for analyses of clinical effectiveness of MNT; more than 5000 participants from 12 countries included. Pooled analysis for various cardiometabolic risk factors.
Multiple MNT Sessions Lower Risk Factors, Save Money. Medical nutrtion therapy vs control was linked to improvements in LDL, HDL, and triglyceride levels plus improvements in total cholesterol, A1c, fasting blood glucose, and BMI. Cost savings of $638-$1456 per patient/year.
Clinical Implications. Evidence supports cost benefits, clinical effectiveness of MNT for cardiometabolic risk delivered by RDN in outpatient setting. Greater improvements were seen with multiple face-to-face RDN visits over longer time periods.
Take Home Points
Source: Sikand G, Cole RE, Handu D, et al. Clinical and cost benefits of medical nutrition therapy by registered dietitian nutritionists for management of dyslipidemia: A systematic review and meta-analysis. J Clin Lipidol. 2018 Jul 3. pii: S1933-2874(18)30274-5. doi: 10.1016/j.jacl.2018.06.016.