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A Naturopathic Approach to the Prevention of Cardiovascular Disease: Cost-Effectiveness Analysis of a Pragmatic Multi-Worksite Randomized Clinical Trial

Herman, Patricia M. ND, PhD; Szczurko, Orest ND, MSc; Cooley, Kieran ND, MSc; Seely, Dugald ND, MSc

Journal of Occupational and Environmental Medicine: February 2014 - Volume 56 - Issue 2 - p 171–176
doi: 10.1097/JOM.0000000000000066
Original Articles

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 Identifier: NCT00718796.

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.

Address correspondence to: Patricia M. Herman, ND, PhD, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407 (

This project was funded by the Joint Benefits Committee of the Canadian Union of Postal Workers and the Canada Post Corporation. During the study, Dr Cooley was supported by a SickKids Foundation Training Award in Complementary/Alternative Health Care.

The authors declare no conflicts of interest.

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Copyright © 2014 by the American College of Occupational and Environmental Medicine