Should food or supplements be used in the community for the treatment of disease-related malnutrition?
Should food or supplements be used in the community for the treatment of disease-related malnutrition?
Strategies are needed for community-based treatment of disease-related malnutrition (DRM), which is a common debilitating condition that in the UK is estimated to cost >£7×10? annually. Whilst dietary fortification and counselling are often used as a first-line treatment for malnutrition, the numbers of dietitians available to undertake and oversee such practices are currently insufficient to address the extent of DRM in primary care. Although dietary fortification and counselling can improve nutritional (primarily energy) intake, the evidence base for this practice is weak and it needs addressing with well-designed trials that assess clinically-relevant outcome measures and costs. Liquid oral nutritional supplements (ONS) are increasingly used in the community, often in combination with dietary counselling. The larger evidence base of trials that have assessed ONS suggests that nutritional intake and some functional outcomes can be improved in some patient groups in the community. Although meta-analysis indicates significant reductions in mortality (odds ratio 0·59 (95% CI 0·48, 0·72), n 3258) and complication rates (odds ratio 0·41 (95% CI 0·31, 0·53), n 1710) with ONS v. routine care, few of these studies are community based. Thus, the impact of ONS on clinical outcome, healthcare use and costs requires further assessment. Similarly, the clinical and cost efficacy of other strategies (e.g. sensory enhancement, music, behavioural therapy), alone or in combination with other treatments, requires greater investigation in order to meet the challenge of treating DRM more effectively and cheaply in the future.
malnutrition, supplements, dietetic counselling, food fortification, primary care
325-333
Stratton, Rebecca J.
c6a5ead1-3387-42e7-8bea-5ac7d969d87b
2005
Stratton, Rebecca J.
c6a5ead1-3387-42e7-8bea-5ac7d969d87b
Stratton, Rebecca J.
(2005)
Should food or supplements be used in the community for the treatment of disease-related malnutrition?
Proceedings of the Nutrition Society, 64 (3), .
(doi:10.1079/PNS2005439).
Abstract
Strategies are needed for community-based treatment of disease-related malnutrition (DRM), which is a common debilitating condition that in the UK is estimated to cost >£7×10? annually. Whilst dietary fortification and counselling are often used as a first-line treatment for malnutrition, the numbers of dietitians available to undertake and oversee such practices are currently insufficient to address the extent of DRM in primary care. Although dietary fortification and counselling can improve nutritional (primarily energy) intake, the evidence base for this practice is weak and it needs addressing with well-designed trials that assess clinically-relevant outcome measures and costs. Liquid oral nutritional supplements (ONS) are increasingly used in the community, often in combination with dietary counselling. The larger evidence base of trials that have assessed ONS suggests that nutritional intake and some functional outcomes can be improved in some patient groups in the community. Although meta-analysis indicates significant reductions in mortality (odds ratio 0·59 (95% CI 0·48, 0·72), n 3258) and complication rates (odds ratio 0·41 (95% CI 0·31, 0·53), n 1710) with ONS v. routine care, few of these studies are community based. Thus, the impact of ONS on clinical outcome, healthcare use and costs requires further assessment. Similarly, the clinical and cost efficacy of other strategies (e.g. sensory enhancement, music, behavioural therapy), alone or in combination with other treatments, requires greater investigation in order to meet the challenge of treating DRM more effectively and cheaply in the future.
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Published date: 2005
Keywords:
malnutrition, supplements, dietetic counselling, food fortification, primary care
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Local EPrints ID: 26001
URI: http://eprints.soton.ac.uk/id/eprint/26001
ISSN: 0029-6651
PURE UUID: 8cf54627-2573-4f9f-b461-f82700bc31c7
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Date deposited: 21 Apr 2006
Last modified: 15 Mar 2024 07:07
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Author:
Rebecca J. Stratton
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