The costs and effects of two different lipid intervention programmes in primary health care

• Objective. To compare the costs and effects of two different intervention strategies for the nonpharmacological treatment of hypercholesterolaemia. Design. Randomized, controlled trial. Subjects were randomly allocated to one of two intervention models and followed up for 1 year. Setting. Vårby Health Centre, a primary care practice located in a suburb of Stockholm. Subjects. Subjects with a total serum cholesterol in the range 7.0–7.8 mmol L−1 and no signs of ischaemic heart disease or diabetes mellitus, randomized to a low‐intensity (n = 35) or medium‐intensity (n = 41) intervention. Intervention. Two strategies were used, one labelled medium‐intensity strategy which followed national current guidelines for nonpharmacological treatment of hypercholesterolaemia, the other was a low‐intensity strategy. Main outcome measures. Total serum cholesterol and intervention costs. Results. Both intervention strategies resulted in small (mean 3.5%) decreases in total cholesterol with no significant difference between the groups. The cost per subject in the low‐intensity group was SEK 753 and in the medium‐intensity group SEK 3614. Conclusions. Because the effect of the two intervention programmes did not differ, the low‐intensity programme is to be preferred from a cost‐effectiveness point of view. If only one‐third of the population in Stockholm county with cholesterol levels ≥ 6.5 mmol L−1 are discovered by the primary health care system, and follow the treatment advice, the net savings in the low‐intensity model compared to the current guidelines here presented as the moderate‐intensity model, would be SEK 93 million.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)

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