None listed
Conditions
Brief summary
Malnutrition is common among hip fracture patients and results in adverse outcomes. The primary aim of this study is to assess the feasibility of intervention delivery and evaluation design in preparation for a larger trial to determine whether providing high energy, high protein meals to older patients following hospitalisation for hip fracture improves patient reported measures and health related outcomes. Primary outcomes relate to feasibility of the intervention and evaluation design. Secondary outcomes include quality of life, patient-reported experience measures, nutritional, functional and health outcomes, and likelihood of cost-effectiveness. This study has potential to improve quality of life and other health outcomes post hospitalisation for hip fracture. If the intervention is shown to be feasible to deliver and evaluate, further research will assess clinical and cost effectiveness.
Interventions
Once recruited, patients will be enrolled in the study and given an identification (ID) number. They will be sequentially recruited into the control group (pre-implementation phase) and intervention groups (implementation phase). The first 70 patients will be recruited into the control group and the following 70 will be recruited into the intervention group). Intervention: Patients in the intervention (implementation phase) group will receive usual care which includes: - Timely surgery - Orthogeriatric co-care - Multidisciplinary, multimodal inpatient nutrition care, including: o Nutrition assessment o High protein/energy diet choices o High protein/energy dietary advice o High protein/energy oral nutrition supplements o Medical management of nutrition impacting symptoms o Mealtime assistance and support o Coordination of care including consideration of post-discharge oral nutrition supplements and/or Meals on Wheels, referral to primary care provider including discharge summary with nutrition status / nutrition care plan documented. Plus in-kind provision of home delivery of Lite-n-Easy full meal package (3 meals/day for 8 weeks) post hospital discharge, per standard processes defined by Lite-n-Easy: - Provision of patient-selected breakfast, lunch and dinner meals from the ‘My Choice’ protein- and energy-dense range (details found at https://www.liteneasy.com.au/my-choice) - Weekly contact from the Lite-n-Easy call centre regarding meal plan choices for the following week and/or any issues regarding products or delivery; and - To- or in-house delivery as per the individual’s preference. Participants are permitted to consume meals outside of the provisions from Lite-n-Easy. Food intake will not be supervised, however food intake will be collected at 4-weeks and 8-weeks post discharge, using a 24hr recall methodology. No other strategies will be used to monitor intake or adherence to meals.
Sponsors
Study design
Eligibility
Inclusion criteria
(a) =/>65 years; (b) able to provide informed consent (cognitively intact, able to communicate in English); (c) admitted to study site Hip Fracture Unit with hip fracture, proximal femur fracture or peri-prosthetic fracture undergoing surgical intervention and discharged directly home or transferred internally to study site Rehabilitation or GEM Units with aim for home discharge; (d) being discharged to their own home and identified as having to contribute to their own meal preparation following hospital discharge; and (e) remain diagnosed as frail or pre-frail, and malnourished or at risk of malnutrition as assessed using the Mini Nutritional Assessment Short Form within 5 days of discharge
Exclusion criteria
(a) critical or terminal illness; (b) metastatic bone disease or pathological fracture; (c) food allergies, no microwave, inadequate freezer space, not consenting to weekly delivery, or not consenting to phone contact provision to vendor to coordinate supply of meals (intervention group only); (d) ASA score 5; (e) living >50km travel distance from study site; or (f) primary treating geriatrician recommended patient not for inclusion