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Robinson J, Nitschke E, Tovar A, Mattar L, Gottesman K, Hamlett P, Rozga M. Nutrition and Physical Activity Interventions for Adults in the General Population: A Position Paper of the Academy of Nutrition and Dietetics and the American Council on Exercise. J Acad Nutr Diet 2024; 124:1347-1356. [PMID: 39029585 DOI: 10.1016/j.jand.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/21/2024]
Abstract
It is the position of the Academy of Nutrition and Dietetics and the American Council on Exercise that nutrition and physical activity interventions delivered by qualified nutrition and exercise practitioners, within their scopes of practice, can improve lifestyle behaviors and cardiometabolic risk factors for adults in the general population. Effective interventions require client-centered, evidence-based care provided by skilled practitioners using inclusive, dynamic methods, and collaboration with an interprofessional team, as appropriate. Increased access to evidence-based nutrition and physical activity interventions is necessary to improve public health and should be a target for policymakers, health care systems, and practitioners. Adults who attain a nutritious diet and adequate physical activity have improved overall health compared with their counterparts. However, most adults do not meet population recommendations. Qualified nutrition and exercise practitioners can collaborate with clients and interprofessional teams to provide nutrition and physical activity interventions and improve outcomes. However, recent guidelines have identified a need for guidance on best practices for delivering behavioral lifestyle counseling, referring to other practitioners, and improving access to disease prevention services. This Academy of Nutrition and Dietetics Position Paper aims to address common barriers for nutrition and exercise practitioners providing nutrition and physical activity interventions for adults in the general population, and best practices for overcoming these barriers. Collective action from interprofessional practitioners and implementation partners can increase access to high-quality, individualized services to prevent disease and improve health and well-being on a population level. This position was approved in July 2024 and will remain in effect until December 31, 2031.
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Affiliation(s)
- Justin Robinson
- Kinesiology Department, Point Loma Nazarene University, San Diego, California
| | - Erin Nitschke
- Department of Exercise Science, Laramie County Community College, Cheyenne, Wyoming
| | | | - Lama Mattar
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Lebanon
| | - Kimberly Gottesman
- Department of Nutrition and Food Science, California State University Los Angeles, Los Angeles, California
| | - Peggy Hamlett
- Department of Kinesiology, Washington State University, Pullman, Washington
| | - Mary Rozga
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, Illinois.
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Galekop MMJ, Del Bas JM, Calder PC, Uyl-De Groot CA, Redekop WK. A health technology assessment of personalized nutrition interventions using the EUnetHTA HTA Core Model. Int J Technol Assess Health Care 2024; 40:e15. [PMID: 38444327 DOI: 10.1017/s0266462324000060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Poor nutrition links to chronic diseases, emphasizing the need for optimized diets. The EU-funded project PREVENTOMICS, introduced personalized nutrition to address this. This study aims to perform a health technology assessment (HTA) comparing personalized nutrition interventions developed through this project, with non-personalized nutrition interventions (control) for people with normal weight, overweight, or obesity. The goal is to support decisions about further development and implementation of personalized nutrition. METHODS The PREVENTOMICS interventions were evaluated using the European Network for HTA Core Model, which includes a methodological framework that encompasses different domains for value assessment. Information was gathered via [1] different statistical analyses and modeling studies, [2] questions asked of project partners and, [3] other (un)published materials. RESULTS Clinical trials of PREVENTOMICS interventions demonstrated different body mass index changes compared to control; differences ranged from -0.80 to 0.20 kg/m2. Long-term outcome predictions showed generally improved health outcomes for the interventions; some appeared cost-effective (e.g., interventions in UK). Ethical concerns around health inequality and the lack of specific legal regulations for personalized nutrition interventions were identified. Choice modeling studies indicated openness to personalized nutrition interventions; decisions were primarily affected by intervention's price. CONCLUSIONS PREVENTOMICS clinical trials have shown promising effectiveness with no major safety concerns, although uncertainties about effectiveness exist due to small samples (n=60-264) and short follow-ups (10-16 weeks). Larger, longer trials are needed for robust evidence before implementation could be considered. Among other considerations, developers should explore financing options and collaborate with policymakers to prevent exclusion of specific groups due to information shortages.
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Affiliation(s)
| | | | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Carin A Uyl-De Groot
- Erasmus School of Health, Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - William Ken Redekop
- Erasmus School of Health, Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Galekop MMJ, Uyl-de Groot C, Redekop WK. Economic Evaluation of a Personalized Nutrition Plan Based on Omic Sciences Versus a General Nutrition Plan in Adults with Overweight and Obesity: A Modeling Study Based on Trial Data in Denmark. PHARMACOECONOMICS - OPEN 2024; 8:313-331. [PMID: 38113009 PMCID: PMC10883904 DOI: 10.1007/s41669-023-00461-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Since there is no diet that is perfect for everyone, personalized nutrition approaches are gaining popularity to achieve goals such as the prevention of obesity-related diseases. However, appropriate choices about funding and encouraging personalized nutrition approaches should be based on sufficient evidence of their effectiveness and cost-effectiveness. In this study, we assessed whether a newly developed personalized plan (PP) could be cost-effective relative to a non-personalized plan in Denmark. METHODS Results of a 10-week randomized controlled trial were combined with a validated obesity economic model to estimate lifetime cost-effectiveness. In the trial, the intervention group (PP) received personalized home-delivered meals based on metabolic biomarkers and personalized behavioral change messages. In the control group these meals and messages were not personalized. Effects were measured in body mass index (BMI) and quality of life (EQ-5D-5L). Costs [euros (€), 2020] were considered from a societal perspective. Lifetime cost-effectiveness was assessed using a multi-state Markov model. Univariate, probabilistic sensitivity, and scenario analyses were performed. RESULTS In the trial, no significant differences were found in the effectiveness of PP compared with control, but wide confidence intervals (CIs) were seen [e.g., BMI (-0.07, 95% CI -0.51, 0.38)]. Lifetime estimates showed that PP increased costs (€520,102 versus €518,366, difference: €1736) and quality-adjusted life years (QALYs) (15.117 versus 15.106, difference: 0.011); the incremental cost-utility ratio (ICUR) was therefore high (€158,798 to gain one QALY). However, a 20% decrease in intervention costs would reduce the ICUR (€23,668 per QALY gained) below an unofficial gross domestic product (GDP)-based willingness-to-pay threshold (€47,817 per QALY gained). CONCLUSION On the basis of the willingness-to-pay threshold and the non-significant differences in short-term effectiveness, PP may not be cost-effective. However, scaling up the intervention would reduce the intervention costs. Future studies should be larger and/or longer to reduce uncertainty about short-term effectiveness. TRIAL REGISTRATION NUMBER ClinicalTrials.gov registry (NCT04590989).
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Affiliation(s)
| | - Carin Uyl-de Groot
- Erasmus Universiteit Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
| | - William Ken Redekop
- Erasmus Universiteit Rotterdam, Erasmus School of Health Policy and Management, Rotterdam, The Netherlands
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Morgan-Bathke M, Baxter SD, Halliday TM, Lynch A, Malik N, Raynor HA, Garay JL, Rozga M. Weight Management Interventions Provided by a Dietitian for Adults with Overweight or Obesity: An Evidence Analysis Center Systematic Review and Meta-Analysis. J Acad Nutr Diet 2023; 123:1621-1661.e25. [PMID: 35788061 DOI: 10.1016/j.jand.2022.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 03/04/2022] [Accepted: 03/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity is associated with a multitude of comorbidities and considerable health care costs. OBJECTIVE The objective of this review was to examine the efficacy of weight management interventions provided by a registered dietitian or international equivalent (referred to as "dietitian"). METHODS This systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effect of weight management interventions provided by a dietitian, compared with usual care or no intervention, on several cardiometabolic outcomes and quality of life in adults with overweight or obesity. MEDLINE, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and CINAHL databases were searched for eligible RCTs published between January 2008 and January 2021 in the English language. Meta-analyses were conducted using a random-effects model, publication bias was assessed using funnel plots and Egger's statistics, and heterogeneity was assessed by interpreting I2 values. Efficacy of intervention components, such as telehealth or group contacts, were explored in sub-group analyses. Version 2 of the risk-of-bias tool for RCTs was used to assess risk of bias. The Grading of Recommendations Assessment, Development and Evaluation method was used to determine certainty of evidence. RESULTS This systematic review included 62 RCTs. Compared with control conditions, weight management interventions provided by a dietitian resulted in improved body mass index (mean difference [MD] -1.5; 95% CI -1.74 to -1.26; moderate evidence certainty); percent weight loss (MD -4.01%; 95% CI -5.26% to -2.75%; high evidence certainty); waist circumference (MD -3.45 cm; 95% CI -4.39 to -2.51 cm; high evidence certainty); blood pressure (MD -3.04 mm Hg; 95% CI -5.10 to -0.98 mm Hg and MD -1.99 mm Hg; 95% CI -3.02 to -0.96 mm Hg for systolic blood pressure and diastolic blood pressure, respectively; moderate and low evidence certainty); and quality of life using the 36-Item Short Form Survey (MD 5.84; 95% CI 2.27 to 9.41 and 2.39; 95% CI 1.55 to 3.23 for physical and mental quality of life, respectively; low and moderate evidence certainty). CONCLUSIONS For adults with overweight or obesity, weight management interventions provided by a dietitian are efficacious for improving several examined cardiometabolic outcomes and quality of life.
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Affiliation(s)
| | | | - Tanya M Halliday
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT
| | - Amanda Lynch
- Department of Interdisciplinary Health Sciences, Oakland University, Rochester, MI
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University, San Bernardino, San Bernardino, CA
| | - Hollie A Raynor
- College of Education, Health, and Human Sciences, University of Tennessee Knoxville, Knoxville, TN
| | - Jessica L Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse NY
| | - Mary Rozga
- Academy of Nutrition and Dietetics, Chicago, IL.
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Robinson J, Nitschke E, Tovar A, Mattar L, Gottesman K, Hamlett P, Rozga M. Nutrition and Physical Activity Interventions Provided by Nutrition and Exercise Practitioners for the General Population: An Evidence-Based Practice Guideline From the Academy of Nutrition and Dietetics and American Council on Exercise. J Acad Nutr Diet 2023; 123:1215-1237.e5. [PMID: 37061182 DOI: 10.1016/j.jand.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 04/17/2023]
Abstract
A nutritious diet and adequate physical activity vitally contribute to disease prevention, but most adults do not meet population-based dietary and physical activity recommendations. Qualified nutrition and exercise practitioners can address challenges to adopting healthy lifestyle behaviors by providing consistent, individualized, and evidence-based education and programming within their professional scopes of practice to improve client outcomes. The objective of this evidence-based practice guideline is to inform practice decisions for nutrition and exercise practitioners providing nutrition and physical activity interventions for adults who are healthy or have cardiometabolic risk factors, but no diagnosed disease. Evidence from a systematic review was translated to practice recommendations using an evidence-to-decision framework by an interdisciplinary team of nutrition and exercise practitioners and researchers. This evidence-based practice guideline does not provide specific dietary or physical activity recommendations but rather informs nutrition and exercise practitioners how they may utilize existing guidelines for the general population to individualize programming for a range of clients. This evidence-based practice guideline provides widely applicable recommendation statements and a detailed framework to help practitioners implement the recommendations into practice. Common barriers and facilitators encountered when delivering nutrition and physical activity interventions, such as adherence to professional scopes of practice; methods to support behavior change; and methods to support inclusion, diversity, equity, and access, are discussed. Nutrition and exercise practitioners can consistently provide individualized, practical, and evidence-based interventions by seeking to understand their clients' needs, circumstances, and values and by co-creating interventions with the client and their allied health team.
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Affiliation(s)
- Justin Robinson
- Kinesiology Department, Point Loma Nazarene University, San Diego, California
| | - Erin Nitschke
- Department of Exercise Science, Laramie County Community College, Cheyenne, Wyoming
| | | | - Lama Mattar
- Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Lebanon
| | - Kimberly Gottesman
- Department of Nutrition and Food Science, California State University Los Angeles, Los Angeles, California
| | - Peggy Hamlett
- Department of Kinesiology, Washington State University Pullman, Washington
| | - Mary Rozga
- Evidence Analysis Center, Academy of Nutrition and Dietetics, Chicago, Illinois.
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Parra-Gómez LA, Galeano L, Chacón-Manosalva M, Camacho P. [Barriers to knowledge, treatment, and control of hypertension in Latin America: a scoping reviewBarreiras ao conhecimento, tratamento e controle da hipertensão arterial na América Latina: uma revisão de escopo]. Rev Panam Salud Publica 2023; 47:e26. [PMID: 36788962 PMCID: PMC9910558 DOI: 10.26633/rpsp.2023.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 09/26/2022] [Indexed: 02/11/2023] Open
Abstract
Objective Group the barriers to knowledge, treatment, and control of hypertension in patients in Latin America through a scoping review. Methods A scoping review was conducted in accordance with the Arksey and O'Malley methodological framework and the PRISMA guidelines for systematic reviews and meta-analyses. Searches were carried out in the PubMed, Virtual Health Library, and Scopus databases. Blind and independent selection was conducted in the RAYYAN QCRI application. Finally, the results of the selected studies were addressed narratively. Results Eight qualitative and quantitative studies that fit the research question were included. The most frequently described barriers are systemic barriers that hinder comprehensive and equitable access to health care and medication, as well as a lack of educational programs, personalized interventions to improve adherence to treatments, and lifestyle changes. Economic factors are critical in Latin America, hindering access to the health system and changes to lifestyles due to the costs of transportation, medical appointments, and medicines. Conclusions The detected barriers affect all dimensions of adherence to treatment; among the most important barriers are decision makers who lack education and positioning with respect to care of hypertension.
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Affiliation(s)
- Laura Alejandra Parra-Gómez
- Subdirección de Investigación, Innovación y EducaciónClínica FOSCALFloridablancaColombiaSubdirección de Investigación, Innovación y Educación, Clínica FOSCAL, Floridablanca, Colombia.
| | - Luis Galeano
- Subdirección de Investigación, Innovación y EducaciónClínica FOSCALFloridablancaColombiaSubdirección de Investigación, Innovación y Educación, Clínica FOSCAL, Floridablanca, Colombia.
| | - María Chacón-Manosalva
- Subdirección de Investigación, Innovación y EducaciónClínica FOSCALFloridablancaColombiaSubdirección de Investigación, Innovación y Educación, Clínica FOSCAL, Floridablanca, Colombia.
| | - Paul Camacho
- Subdirección de Investigación, Innovación y EducaciónClínica FOSCALFloridablancaColombiaSubdirección de Investigación, Innovación y Educación, Clínica FOSCAL, Floridablanca, Colombia.
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Sulo S, Schwander B, Brunton C, Gomez G, Misas JD, Gracia DA, Chavarro-Carvajal DA, Venegas-Sanabria LC, Cano-Gutiérrez C. Nutrition-Focused Care for Community-Living Adults: Healthcare Utilization and Economic Benefits. Value Health Reg Issues 2022; 32:70-77. [PMID: 36099802 DOI: 10.1016/j.vhri.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/08/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES We assessed the impact of a recently reported nutritional quality improvement program (QIP) on healthcare resource utilization and costs for older, community-living adults in Bogotá, Colombia. METHODS The study included 618 community-dwelling, older adults (> 60 years) who were at risk or malnourished and receiving outpatient clinical care. The intervention was a QIP that emphasized nutritional screening, dietary education, lifestyle counseling, 60-day consumption of oral nutritional supplements, and 90-day follow-up. For economic modeling, we performed 90-day budget impact and cost-effectiveness analyses from a Colombian third-party payer perspective. The base-case analysis quantified mean healthcare resource use in the QIP study population. Analysis was based on mean input values (deterministic) and distributions of input parameters (probabilistic). As the deterministic analysis provided a simple point estimate, the cost-effectiveness analysis focused on the probabilistic results informed by 1000 iterations of a Monte-Carlo simulation. RESULTS Results showed that the total use of healthcare resources over 90 days was significantly reduced by > 40% (hospitalizations were reduced by approximately 80%, emergency department visits by > 60%, and outpatient clinical visits by nearly 40%; P < .001). Based on economic modeling, total cost savings of $129 740 or per-patient cost savings of $210 over 90 days could be attributed to the use of nutritional QIP strategies. Total cost savings equated to nearly twice the initial investment for QIP intervention; that is, the per-dollar return on investment was $1.82. CONCLUSIONS For older adults living in the community in Colombia, the use of our nutritional QIP improved health outcomes while lowering costs of healthcare and was thus cost-effective.
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Affiliation(s)
- Suela Sulo
- Abbott Laboratories, Abbott Park, IL, USA.
| | - Bjoern Schwander
- Agency for Health Economic Assessment and Dissemination GmbH, Lörrach, Germany
| | | | | | | | | | | | | | - Carlos Cano-Gutiérrez
- Pontificia Universidad Javeriana, Bogotá, Colombia; Hospital Universitario San Ignacio, Bogotá, Colombia
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Schuetz P, Sulo S, Walzer S, Krenberger S, Stagna Z, Gomes F, Mueller B, Brunton C. Economic Evaluation of Individualized Nutritional Support for Hospitalized Patients with Chronic Heart Failure. Nutrients 2022; 14:nu14091703. [PMID: 35565669 PMCID: PMC9099480 DOI: 10.3390/nu14091703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/13/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023] Open
Abstract
Background Malnutrition is a highly prevalent risk factor in hospitalized patients with chronic heart failure (CHF). A recent randomized trial found lower mortality and improved health outcomes when CHF patients with nutritional risk received individualized nutritional treatment. Objective To estimate the cost-effectiveness of individualized nutritional support in hospitalized patients with CHF. Methods This analysis used data from CHF patients at risk of malnutrition (N = 645) who were part of the Effect of Early Nutritional Therapy on Frailty, Functional Outcomes and Recovery of Undernourished Medical Inpatients Trial (EFFORT). Study patients with CHF were randomized into (i) an intervention group (individualized nutritional support to reach energy, protein, and micronutrient goals) or (ii) a control group (receiving standard hospital food). We used a Markov model with daily cycles (over a 6-month interval) to estimate hospital costs and health outcomes in the comparator groups, thus modeling cost-effectiveness ratios of nutritional interventions. Results With nutritional support, the modeled total additional cost over the 6-month interval was 15,159 Swiss Francs (SF). With an additional 5.77 life days, the overall incremental cost-effectiveness ratio for nutritional support vs. no nutritional support was 2625 SF per life day gained. In terms of complications, patients receiving nutritional support had a cost savings of 6214 SF and an additional 4.11 life days without complications, yielding an incremental cost-effectiveness ratio for avoided complications of 1513 SF per life day gained. Conclusions On the basis of a Markov model, this economic analysis found that in-hospital nutritional support for CHF patients increased life expectancy at an acceptable incremental cost-effectiveness ratio.
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Affiliation(s)
- Philipp Schuetz
- Medical University Department, Kantonsspital Aarau, 5001 Aarau, Switzerland;
- Medical Faculty, University of Basel, 4001 Basel, Switzerland
- Correspondence: ; Fax: +41-62-838-4100
| | - Suela Sulo
- Abbott Nutrition, Chicago, IL 60045, USA; (S.S.); (C.B.)
| | - Stefan Walzer
- MArS Market Access & Pricing Strategy GmbH, 79576 Weil am Rhein, Germany; (S.W.); (S.K.)
- Health Care Management, State University Baden-Wuerttemberg, 70174 Loerrach, Germany
- Social Work & Health Care, University of Applied Sciences Ravensburg-Weingarten, 88250 Weingarten, Germany
| | - Sebastian Krenberger
- MArS Market Access & Pricing Strategy GmbH, 79576 Weil am Rhein, Germany; (S.W.); (S.K.)
| | - Zeno Stagna
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, 4001 Bern, Switzerland;
| | - Filomena Gomes
- NOVA Medical School, Universidade NOVA de Lisboa, 1169-056 Lisboa, Portugal;
| | - Beat Mueller
- Medical University Department, Kantonsspital Aarau, 5001 Aarau, Switzerland;
- Medical Faculty, University of Basel, 4001 Basel, Switzerland
| | - Cory Brunton
- Abbott Nutrition, Chicago, IL 60045, USA; (S.S.); (C.B.)
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Barnes KA, Szewczyk Z, Kelly JT, Campbell KL, Ball LE. How cost-effective is nutrition care delivered in primary healthcare settings? A systematic review of trial-based economic evaluations. Nutr Rev 2021; 80:1480-1496. [PMID: 34605888 DOI: 10.1093/nutrit/nuab082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CONTEXT Nutrition care is an effective lifestyle intervention for the treatment and prevention of many noncommunicable diseases. Primary care is a high-value setting in which to provide nutrition care. OBJECTIVE The objective of this review was to evaluate the cost-effectiveness of nutrition care interventions provided in primary care settings. DATA SOURCES Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials, EconLit, and the National Health Service Economic Evaluation Database (NHS EED) were searched from inception to May 2021. DATA EXTRACTION Data extraction was guided by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) reporting guidelines. Randomized trials of nutrition interventions in primary care settings were included in the analysis if incremental cost-effectiveness ratios were reported. The main outcome variable incremental cost-effectiveness ratios (ICERs) and reported interpretations were used to categorize interventions by the cost-effectiveness plane quadrant. RESULTS Of 6837 articles identified, 10 were included (representing 9 studies). Eight of the 9 included studies found nutrition care in primary care settings to be more costly and more effective than usual care . High study heterogeneity limited further conclusions. CONCLUSION Nutrition care in primary care settings is effective, though it requires investment; it should, therefore, be considered in primary care planning. Further studies are needed to evaluate the long-term cost-effectiveness of providing nutrition care in primary care settings. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020201146.
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Affiliation(s)
- Katelyn A Barnes
- Healthy Primary Care, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
| | - Zoe Szewczyk
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW, Australia.,School of Medicine and Public Health, the University of Newcastle, Callaghan, NSW, Australia
| | - Jaimon T Kelly
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.,Centre for Online Health, the University of Queensland, Brisbane, QLD, Australia.,Centre for Health Services Research, the University of Queensland, Brisbane, QLD, Australia
| | - Katrina L Campbell
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.,Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Brisbane, Australia
| | - Lauren E Ball
- Healthy Primary Care, Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia
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Dong OM. Using the Diffusion of Innovation Theory to Understand the Challenges and Opportunities to Advancing Use of Nutrigenetics in Clinical Practice. Lifestyle Genom 2021; 14:124-128. [PMID: 34289479 DOI: 10.1159/000517760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/08/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Olivia M Dong
- Department of Medicine, Duke Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, Durham, North Carolina, USA.,Durham VA Health Care System, United States Department of Veterans Affairs, Durham, North Carolina, USA
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11
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Epstein D. Nutrition Economics: Celebrating Cross-Disciplinary Collaboration. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:313-316. [PMID: 33641763 DOI: 10.1016/j.jval.2020.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 12/31/2020] [Indexed: 06/12/2023]
Affiliation(s)
- David Epstein
- Department of Applied Economics, University of Granada, Granada, Spain.
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