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Doctoral Thesis
Full name
Albino Rodrigues Alvarez
Knowledge Area
Date of Defense
São Paulo, 2003
Campino, Antonio Carlos Coelho (President)
Cyrillo, Denise Cavallini
Diaz, Maria Dolores Montoya
Fisberg, Regina Mara
Vieira, Joaquim Edson
Title in Portuguese
Um estudo de custo-eficácia com as abordagens nutricional e medicamentosa no tratamento da dislipidemia em pacientes HIV/AIDS
Keywords in Portuguese
Nutrição humana
Abstract in Portuguese
Esse estudo pretendeu fazer uma análise custo-eficácia de duas estratégias de tratamento de hiperlipidemia em pacientes HIV/AIDS, uma de carácter nutricional e a outra de carácter medicamentosa, mais precisamente com pravastatina e bezafibrato, respectivamente para casos de colesterol e triglicérides elevados, num horizonte entre 3 e 12 meses. Os dados foram coletados no CRT-AIDS de São Paulo. Encontraram-se resultados similares em termos de eficácia no caso da hipercolesterolemia, a um custo menor via abordagem nutricional. As dosagens iniciais em ambos os grupos se revelaram similares. No caso da hipertrigliceridemia, verificou-se o mesmo efeito proporcional, apesar de que se deve considerar que as dosagens iniciais eram bastante diversas, apresentando os pacientes medicados níveis mais altos de triglicérides. Essa maior custo-eficácia da abordagem nutricional aqui encontrada, deve ser ponderada, também, com as limitações encontradas no estudo, quanto à abordagem de questões como a adesão dos pacientes aos tratamentos, e características do próprio processo diagnóstico. Apesar disso, os resultados do trabalho sugerem uma especial atenção com questões ligadas à dieta e estilo de vida, não num sentido competitivo, mas complementariamente em relação às terapias medicamentosas, quando estas se fizerem necessárias.
Title in English
A cost-efficacy analysis with the nutritional and medicinal strategies for the treatment of dyslipidemia in HIV/AIDS patients
Keywords in English
Human nutrition
Abstract in English
This study intended to make a cost-efficacy analysis of 2 options for the treatment of dyslipidemia in HIV/AIDS patients, the nutritional and the medical one, more strictly with pravastatin and bezafibrate, respectively for cases of raised cholesterol and triglycerides leveis, within 3 and 12 months. The data were collected at the CRT/AIDS de São Paulo. The study found similar results in terms of effectiveness in the hypercholesterolemia groups, with a smaller cost through the nutritional strategy. The initial leveis of cholesterol In both groups were similar. In the case of the hypertriglyceridemic groups the same proportional effect was verified,although it must be considered that the initial dosages were significantly diverse, presenting the medicated patients higher leveis of serum triglycerides. The higher cost-efficacy of nutritional strategies must be weighed with the limitations of this study, as the question of compliance to the treatments and even the diagnostic processo The criteria to choose the appropriate prices were basic to the differentiation between the options and they are a point of permanent discussion by themselves. In spite of these problems the study suggests that a special attention should be given to aspects linked with diet and life style in general, not in a competitive sense, but with complementary objetives in relation with the pharmacologic therapy, if the latter be necessary.
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