Dietitian intervention improves lipid values and saves medication costs inmen with combined hyperlipidemia and a history of niacin noncompliance

We asked if medical nutrition therapy (MNT) administered by registered diet itians 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 hyperlipi demia who were being considered for statin therapy because of a previous hi story of noncompliance with niacin therapy. Subjects participated in an 8-w eek dietitian intervention program as a qualifying requirement before stati n therapy. Patient records were reviewed to determine the beginning and end ing serum lipid concentrations and the number and length of dietitian sessi ons. 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 c holesterol 11% (P < .001), low-density lipoprotein cholesterol 9% (P < .001 ), and triglycerides 22% (P < .0001) and body mass index 2% (P < .0001); MN T raised high-density lipoprotein cholesterol levels 4%. After dietitian in tervention, only 15 of 30 eligible patients required antihyperlipidemic med ications, 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 dol lar 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 tre ating patients with combined hyperlipidemia and recommend consideration of MNT as a cost-effective intervention.