Key result
Telehealth medical nutrition therapy delivers a ~$1.31 return on investment per dollar spent in rural primary care.
Effect estimate: $1.31 return per dollar invested (95% CI 0.69-1.89)
Telehealth-delivered medical nutrition therapy for CVD risk reduction in rural areas provides a positive economic return on investment while building local healthcare capacity and improving patient health literacy.
Supports rural telehealth nutrition programs; leaves open confirmation in larger randomized trials with hard cardiovascular endpoints.
BACKGROUND: The impact of clinical trials extends beyond knowledge gained. However, broader impacts, including social, health and economic benefits to patients and communities are rarely assessed. In rural and remote regions where inclusion of local populations in clinical trials is limited, these assessments are even more rare. The Healthy Rural Hearts (HealthyRHearts) study aimed to reduce cardiovascular disease (CVD) risk in rural Australians through a medical nutrition therapy (MNT) intervention delivered via telehealth following a primary care heart health assessment. This provided an opportunity to evaluate its impacts more broadly and to guide future investment in rural clinical trials. METHODS: Data on the impacts of the HealthyRHearts study were obtained from administrative records, document analysis, relevant websites/databases and in-depth interviews using three methods within the Framework to Assess Impact from Translational Health Research (FAIT). These include (1) a modification of the Payback Framework reported as quantified metrics, (2) a cost-consequence analysis (CCA) to determine return on investment and (3) a narrative account of impact generated from the study using qualitative data. RESULTS: The modified Payback Framework identified significant knowledge advancement through publications, training materials and economic benefits from employment opportunities and leveraged funding. However, the greatest impacts were improvements in rural healthcare and research capacity through training and support offered to dietitians, project staff, general (primary care) practice staff and patients. The majority of patients had improved CVD risk scores, activation in healthcare participation, health literacy and quality of life at trial completion. The CCA demonstrated a modest return of $1.31 ($0.69-1.89) for each Australian dollar invested. Dietitians and general practice staff interviewed identified personal satisfaction as a benefit of participation, with dietitians reporting economic benefits as a result of their new skills. Patients reported that their nutrition knowledge and dietary behaviours improved, leading to perceived improvements in their health and wellbeing. CONCLUSIONS: The HealthyRHearts trial delivered significant impact in knowledge gain, while building healthcare and research capacity and capability in rural communities. Patient and community benefits were also delivered, with a potentially small but positive return on investment, suggesting that investment in rural clinical trials has broad-ranging benefits beyond research outcomes alone.
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Budden et al. (2026) studied Cardiovascular disease risk (n=131). Telehealth medical nutrition therapy clinical trial was evaluated on Return on investment (Cost-Consequence Analysis) ($1.31 return per dollar invested, 95% CI 0.69-1.89). The Healthy Rural Hearts trial delivered significant improvements in rural healthcare capacity and a positive return on investment of $1.31 for each Australian dollar invested.
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