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misc/arrow-dots-black Wetenschapmisc/arrow-dots-blackNumber of consultations, treatment time and effectiveness of dietetic treatment in primary care in the Netherlands: results of the DIEET-project

Number of consultations, treatment time and effectiveness of dietetic treatment in primary care in the Netherlands: results of the DIEET-project

Authors
dr. Eva Leistra,, Ir. Caroelien Schuurman, prof. dr. ir. Peter Weijs
JournalNederlands Tijdschrift voor Voeding & Diëtetiek , Volume 74 , Issue 4
Publication12/09/2019
Afbeelding voor Number of consultations, treatment time and effectiveness of dietetic treatment in primary care in the Netherlands: results of the DIEET-project

Abstract

Introduction

This article describes the number and types of consultations, treatment time and effectiveness of dietetic treatments in primary care in the Netherlands.

Methods

The DIEET (DIEtetics Effective and Towards a sustainable profession) project is a nationwide prospective observational study. Characteristics of clients treated for overweight, Diabetes Mellitus type 2 (DM2), hypercholesterolemia, malnutrition or hypertension were recorded at baseline, and the number and kind of consultations and treatment time was recorded at 9 months. Effectiveness was determined by predefined criteria for weight change, BMI, and/or medication use. Differences in the median number of consultations and treatment time between men/women, clients with a Dutch background or a migration background and with or without referral was tested with a Mann-Whitney U test, between SES groups and primary diagnoses with a Kruskall-Wallis test with post hoc Dunn’s pairwise comparison with Bonferroni correction, and between effective and non-effective treated clients with a Mann-Whitney U test Multivariable logistic regression analysis was done with effectiveness as outcome and number of consultations and treatment time as explanatory factor, corrected for the characteristics of the client (two-sided alpha=0.05).

Results

605 clients met the inclusion criteria, data was available for 393 clients. Mean age was 55,5 ± 14,5 years, 59% was women. Primary diagnoses were overweight (48%), DM2 (35%), hypercholesterolemia (9%), malnutrition (6%), and hypertension (2%). For 41% treatment was still ongoing after 9 months. The median number of consultations was 5 (IQR:3-6), median treatment time was 180 min (IQR:135-225), of which 81% was direct time. The treatment time of 39% of the clients was longer than the reimbursed 180 minutes. Overweight clients received more consultations than clients with DM2 (5 (3-7) versus 4 (3-6); p= 0.02), or hypercholesterolemia (4 (3-5) borderline significant, p=0.10). Differences in treatment time between SES groups were borderline significant; high SES 170 min (IQR 105-210) versus low/middle SES 180 min (IQR middle SES 135-230, IQR low SES 105-210), p=0.08). 47% of the treatments was effective. Clients with an effective treatment received one consultation and 15 minutes more treatment than clients without an effective treatment (p=0.02 en p=0.05).

Conclusion

The median number of consultations was 5 (IQR:3-6), median treatment time was 180 min (IQR:135-225), Clients with an effective treatment within 9 months of dietetic treatment had a median of one consultation and a median consultation time of 15 minutes longer compared to clients with a non-effective treatment. Whether an extra consultation and extra time will increase the effectiveness of a dietary treatment has to be investigated.

Key words: dietetics, effectiveness, primary care

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