Malnutrition
Conditions
Keywords
food, dietician, malnutrition, nutrition risk, quality of life, muscle strength, readmissions, mortality, multimodal
Brief summary
The aim of the study is to implement a nutritional treatment when discharging older patients at risk of malnutrition. Data collected in the study will include an assessment of whether a combination of nutritional treatment and a liaison team reduces the risk of readmissions and mortality, improves nutritional status, physical function and quality of life
Detailed description
During hospitalization, many older patients are at risk of malnutrition. Malnutrition in older adults is related to reduced physical function, more complications, re-admissions, days in hospital and reduced quality of life. As hospitalizations are often short (approximately 5 days), it is important to focus on nutritional intake during the convalescence period. Upon discharge, a "Nutrition Gap" often occurs in practice, where the patient does not consume sufficient nutrition to ensure an optimal convalescence period. The lack of nutritional follow-up in connection with the discharge of older patients has been shown to have a markedly negative effect on, among other things, functional ability and readmissions. A study from Herlev Hospital, where the effect of a nutritional treatment upon discharge of older patients was investigated, showed a significant effect on muscle strength, quality of life and nutritional status. Another study from Herlev Hospital has shown that by associating a clinical dietitian with a liaison team and thus focusing on nutrition, the readmission rate was halved. The problem is that it has not been investigated whether such a cross-sectoral effort can be implemented in practice and the results confirmed. Hypothesis 1 is that it is possible to include and retain the older patients who are discharged with the liaison team for an effort that includes treatment of the risk of malnutrition and that the older participants find the effort relevant Hypothesis 2 is that nutritional treatment will be able to reduce the number of unintended readmissions and thereby be cost-effective. Furthermore, it is expected that the nutritional treatment will increase the participants' nutritional status, muscle strength, muscle mass, quality of life and possibly have a positive effect on mortality.
Interventions
At the day of discharge the intervention group (IG) receives a package containing foods and drinks covering dietary requirements for the next 24 h. Further, a goodie-bag containing samples of protein-rich milk-based drinks is provided. At day 4 after discharge, the IG receives dietetic counselling including a recommendation of daily exercise, and an individual nutrition plan. Information regarding recommendations of nutritional therapy after discharge is systematically and electronically communicated to the municipality. The dietician performes telephone follow-ups on day 30 and a home visit at 12 weeks
Sponsors
Herlev and Gentofte Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Prescription of the Liaison team At nutritional risk according to NRS2002 Age 50+ Can read, hear and understand Danish or English Cognitive able to participate in the study, based on whether they are informed in time, place and own data
Exclusion criteria
Receives enteral or parenteral nutrition Following a special diet including texture modified food and drinks Short life expectancy Not deemed eligible by the project staff
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Eligibility | Assessed at baseline | Eligibility will be assessed as the number of patients who fulfil the inclusion criteria out of the number of patients discharged with the liaison team |
| Recruitment | Assessed at baseline | Recruitment rate will be assessed as the number of patients recruited out of the number of eligible patients |
| Retention | Assessed at three months | Retention rate will be assessed as the number of patients who complete the nutritional treatment out of the total number of patients recruited |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | 30 days, 12 weeks, 6 monts, 1 year and 3 year | health care records |
| Hospital re-admissions | 30 days, 12 weeks, 6 monts, 1 year and 3 year | health care records |
| Health related Quality of life | 12 weeks | Euro-qol tool EQ5D5L |
| Appetite | 30 days, 12 weeks | SNAQ with a score from 5 to 20 where a score at or below 14 can predict weight loss |
| Muscle strenght | 4 days, 30 days, 12 weeks | 30 seconds chair stand |
| Dietary intake | 30 days, 12 weeks | 24 hours recall |
| weight | 4 days, 30 days | body weight measurement |
| muscle mass | 12 weeks | calf circumference |
Countries
Denmark
Contacts
CONTACTTina Munk, Ph D
CONTACTAnne Marie Beck, Ph.d.
Outcome results
None listed