自然疗法预防心血管疾病：一项实用多场所随机临床试验的成本效益分析。
A naturopathic approach to the prevention of cardiovascular disease: cost-effectiveness analysis of a pragmatic multi-worksite randomized clinical trial.
机构信息
From the Center for Health Outcomes and Pharmacoeconomics Research (Dr Herman), University of Arizona, and the RAND Corporation, Santa Monica, Calif; Department of Research and Clinical Epidemiology (Drs Szczurko, Cooley, and Seely), Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada; and Department of Social and Administrative Pharmacy (Drs Szczurko and Cooley), University of Toronto, Toronto, Ontario, Canada.
出版信息
J Occup Environ Med. 2014 Feb;56(2):171-6. doi: 10.1097/JOM.0000000000000066.
OBJECTIVE
To determine the cost-effectiveness of a worksite-based naturopathic (individualized lifestyle counseling and nutritional medicine) approach to primary prevention of cardiovascular disease (CVD).
METHODS
Economic evaluation alongside a pragmatic, multi-worksite, randomized controlled trial comparing enhanced usual care (EUC; usual care plus biometric screening) to the addition of a naturopathic approach to CVD prevention (NC+EUC).
RESULTS
After 1 year, NC+EUC resulted in a net decrease of 3.3 (confidence interval: 1.7 to 4.8) percentage points in 10-year CVD event risk (number needed to treat = 30). These risk reductions came with average net study-year savings of $1138 in societal costs and $1187 in employer costs. There was no change in quality-adjusted life years across the study year.
CONCLUSIONS
A naturopathic approach to CVD primary prevention significantly reduced CVD risk over usual care plus biometric screening and reduced costs to society and employers in this multi-worksite-based study. Trial Registration clinicaltrials.gov Identifier: NCT00718796.
目的
评估基于工作场所的顺势疗法（个性化生活方式咨询和营养医学）在心血管疾病（CVD）一级预防中的成本效益。
方法
在一项实用的、多工作场所、随机对照试验中，对增强的常规护理（EUC；常规护理加生物标志物筛查）与顺势疗法在 CVD 预防中的应用（NC+EUC）进行了经济评估。
结果
1 年后，NC+EUC 使 10 年 CVD 事件风险降低了 3.3 个百分点（置信区间：1.7 至 4.8）（需要治疗的人数=30）。这些风险降低带来了社会成本平均每年节省 1138 美元和雇主成本节省 1187 美元。在研究年度内，生活质量调整生命年没有变化。
结论
在这项基于多工作场所的研究中，CVD 一级预防的顺势疗法方案显著降低了 CVD 风险，相对于常规护理加生物标志物筛查降低了社会和雇主的成本。
试验注册临床Trials.gov 标识符：NCT00718796。
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