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More Than 9 in 10 Primary Care Physicians Say U.S. Health Care System Should Place Greater Emphasis on Nutrition to Manage Chronic Disease
Date:6/10/2009

Survey Conducted with American Dietetic Association Shows Lack of Reimbursement for Nutrition Services Is Key Barrier

WASHINGTON, June 10 /PRNewswire-USNewswire/ -- Ninety-six percent of primary care physicians believe the nation's health care system should place more emphasis on nutrition to treat and manage chronic disease, according to a new survey released today. However, only 12 percent believe physicians currently pay significant attention to nutrition in the context of chronic disease.

"The good news is physicians know nutrition therapy can improve health outcomes," said registered dietitian Jane V. White, PhD, LDN, RD, FADA, with the Department of Family Medicine at the University of Tennessee Graduate School of Medicine, who partnered with the American Dietetic Association on the survey. "Now, it's time to move nutrition services to the forefront in prevention and management of chronic disease."

In the survey, nutrition services were defined as referral to a registered dietitian or recommendation of specific nutrition products.

"Nutrition is more than just eating a healthy diet; for patients with chronic disease nutrition acts as therapy to help them heal faster, respond better to medical care and control their disease," White said.

One of the biggest reasons cited for physicians' failure to address nutrition more frequently as part of chronic disease prevention and management is the lack of direct reimbursement for nutrition services. More than 80 percent of physicians surveyed said lack of reimbursement is either a major reason or the single biggest reason that providing nutrition services is not routine, including one-third who cited it as the biggest factor.

"Registered dietitians and doctors have long known the intrinsic value of nutrition services for their patients," said registered dietitian Martin Yadrick, MS, MBA, RD, FADA, immediate past-president of the American Dietetic Association. "It is now important for lawmakers to recognize the benefits as well and include them as covered benefits in health care reform."

The national online survey of 400 primary care physicians was conducted by Hart Research Associates in association with the American Dietetic Association and the University of Tennessee Graduate School of Medicine, Department of Family Medicine. The results were presented June 10 at a briefing on Capitol Hill attended by nutrition advocates, physicians, researchers and chronic disease organizations.

The findings are especially significant as Congress addresses health care reform and increases the focus on preventive care. According to the Centers for Disease Control and Prevention (CDC), chronic disease accounts for 75 percent of the $2 trillion the U.S. spends annually on health care. Nutrition has been shown to be highly cost-effective in preventing and managing chronic disease, but nutrition services are not a routinely covered health care benefit. In the survey, almost half (46 percent) of physicians agreed the provision of routine nutrition services definitely would be cost effective, while another 44 percent said it would probably be cost effective.

Nearly half of all adults in the U.S. have at least one chronic disease. Primary care physicians are nearly unanimous in their belief that nutrition is a key element in chronic disease: An overwhelming 94 percent of the doctors surveyed believe that nutrition plays a major role in prevention, and 95 percent say nutrition plays a major role in chronic disease management and treatment. On average, they estimate that two in three of their adult patients who have chronic disease would benefit from nutrition services. If the costs were reimbursed by a third-party payer, almost all of the physicians (94 percent) say they would refer more of their patients with chronic ailments for nutrition services than they do now.

Former Senator George McGovern, who has been a prominent advocate for improving nutrition worldwide, encouraged policymakers to take the benefits of nutrition into account in health care reform.

"As Congress takes up health care reform, it is important that the benefits of nutrition therapy be fully recognized. Investments in nutrition research, nutrition programs and nutrition therapy would provide dividends to the taxpayer. Nutrition services should be included in the Medicare program, and in any basic benefit package developed as a result of health care reform," said Sen. McGovern.

The abstract of a new study conducted by researchers at the Ohio State University Center for Health Outcomes, Policy and Evaluation Studies (HOPES) was also released at the briefing. The study, which has been submitted for publication, examined the cost effectiveness of therapeutic nutritional supplements (TNS) in the treatment of pressure ulcers, wounds, and burns. The researchers conducted economic modeling comparing the costs of TNS treatment to the savings from forgoing treatments that would be necessary if TNS was not used. Preliminary results indicate savings from the use of TNS for these conditions could be nearly $1 billion annually in the U.S.

Both studies were conducted with support from Abbott Nutrition, a division of Abbott, the global health care company. The primary care survey and the medical abstract are available at the American Dietetic Association's Web site, www.eatright.org/2009policybriefing.

About the American Dietetic Association

The American Dietetic Association is the world's largest organization of food and nutrition professionals. ADA is committed to improving the nation's health and advancing the profession of dietetics through research, education and advocacy. Visit ADA at www.eatright.org.


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SOURCE American Dietetic Association
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