None listed
Conditions
Brief summary
This research proposes to pilot the methods for a planned randomised controlled trial (RCT) which will test the hypothesis that in-patients aged 65 years and over who are randomly allocated to be screened for nutritional status and to receive appropriate nutritional support will have fewer negative health outcomes, compared to those who receive usual practice. The pilot study will test the feasibility of a multi-disciplinary nutritional support intervention for the population of older people who are at high risk of malnutrition and associated adverse health outcomes, while optimising the activities of a range of existing health services and patient support approaches. This study will implement a simple and efficient form of nutrition screening for men and women aged 65 years and over, who are admitted to the John Hunter Hospital in Newcastle, NSW. Consenting patients will be screened for under-nutrition using the Malnutrition Screening Tool by a Research Assistant who will remain blind to patient study status. Patients will then be randomly allocated, by a data manager, to either the control group, who will receive usual care for their presenting problem, or to the intervention. Patients within the intervention component of the study will be reviewed by a dedicated Nutrition Support Person employed by the study. “Best practice” nutritional care for these patients will be based on the recent Clinical Standards for Food, Fluid and Nutritional Care in Hospitals from Scotland. It is expected that patients will not know which condition they are randomized to, as the intervention is designed to fit seamlessly within normal hospital practice and routines. Follow-up data collection will occur at 6 months post-discharge, and will be conducted by the same Research Assistant as conducted baseline data collection, who will remain blind to patient study status. The main outcomes measures for the pilot will be a change in nutrition status from recruitment to follow-up using the Patient Generated SGA (PG-SGA), and Lean Body Mass. The findings from this study will provide a test of the feasibility of the RCT, which it is hoped will provide a much needed basis for targeting nutritional assessment and services in a growing population of older people, and would be expected to have a major impact on enhancing recovery and quality of life, and reducing length of stay and readmission for those people involved in the intervention component.
Interventions
All consenting patients will be screened using the Malnutrition Screening Tool. Patients randomised to the intervention group will be triaged according to Malnutrition Screening Tool score. Those intervention patients who sco
All consenting patients will be screened using the Malnutrition Screening Tool. Patients randomised to the intervention group will be triaged according to Malnutrition Screening Tool score. Those intervention patients who score less than 2 on the Malnutrition Screening Tool will be provided with the NHMRC dietary guidelines only; those who are screened as "at risk", that is who have a Malnutrition Screening Tool score of 2 to 5, will be referred to a dietitian for Subjective Global Assessment, and, if assessed as malnourished, will be offered multi-disciplinary intervention co-ordinated by a Nutrition Support Person employed by the study, and involving a team of dietitians, social workers, clinical nurse consultants, geriatricians, oral health professionals, speech pathologists, physiotherapists and pharmacists; those who are screened as malnourished, that is who have a Malnutrition Screening Tool score of 6 or more, will be immediately offered multi-disciplinary nutrition support. “Best practice” nutritional care for the latter two groups of patients will be based on the recent Clinical Standards for Food, Fluid and Nutritional Care in Hospitals from Scotland. Intervention will occur during the hospital stay, which is estimated to be up to about 2 weeks, with follow-up at 6 months after discharge.
Sponsors
University of Newcastle
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Are admitted to the John Hunter Hospital in Newcastle, NSW.
Exclusion criteria
Patients who do not have the cognitive capacity to consent to the study (as advised by Nursing staff), those who do not speak English sufficiently well to understand the study requirements, terminally ill patients, and those who are already receiving parenteral nutrition or other artificial feeding at the time of recruitment.
Outcome results
None listed