Food as medicine? Exploring the impact of providing healthy foods on adherence and clinical and economic outcomes.

Autor:	Chen AMH; Cedarville University School of Pharmacy, USA., Draime JA; Cedarville University School of Pharmacy, USA., Berman S; University Health San Antonio, USA., Gardner J; Cincinnati Children's Medical Hospital, USA., Krauss Z; Cedarville University School of Pharmacy, USA., Martinez J; The Marzam Group, USA.
Jazyk:	angličtina
Zdroj:	Exploratory research in clinical and social pharmacy [Explor Res Clin Soc Pharm] 2022 Mar 18; Vol. 5, pp. 100129. Date of Electronic Publication: 2022 Mar 18 (Print Publication: 2022).
DOI:	10.1016/j.rcsop.2022.100129
Abstrakt:	Background: Chronic disease prevalence is increasing. Adherence to dietary guidelines is low (<50%) despite positive impacts in disease progression, clinical outcomes, and medical costs. It is important to summarize the impact of providing medically-tailored meals to patients on adherence rates, clinical outcomes, and potential economic outcomes. Methods: A systematic review was conducted to identify, extract, and appraise food-provision studies from January 1, 2013-May 1, 2018 for heart disease, diabetes (DM), and chronic kidney disease (CKD). The key findings related to adherence and clinical outcomes were compiled. Published literature was utilized to determine the economic impact of key clinical outcomes. Results: Across diseases, 100 articles ( N = 43,175 patients) were included. Dietary adherence was considered "compliant" or ≥ 90% consistently. Significant ( p < 0.05) clinical outcomes included 5-10% LDL reduction, 4-11 mmHg SBP reduction, 30% reduction in metabolic syndrome prevalence, 3-5% weight reduction, 56% lower CKD mortality rates, and increased dialysis-free time (2 years:50%, 5 years:25%, calculated cost savings of 80.6-94.3%). Literature review showed these outcomes would result in decreased: cardiovascular (CV) event risk (20-30% reduction: $5-11 billion annually), hospitalization costs ($1-8 billion), and dialysis rates (25-50% reduction: $14-29 billion annually). For heart failure patients, results include: 16% fewer readmissions (saving $234,096 per 100 patients) and a 38-day shorter length of stay (saving $79,425 per hospitalization). Conclusion: Providing medically-tailored meals significantly increases dietary adherence above 90% and allows patients to realize significantly better chronic disease control. Through this, patients could experience fewer complications (CV events, hospital readmissions and dialysis), resulting in significant annual US healthcare cost reduction of $27-48 billion. (© 2022 The Authors.)
Databáze:	MEDLINE
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