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Managing post-acute malnutrition risk

Managing post-acute malnutrition risk

Research shows that 1 in 3 hospitalized patients is malnourished upon admission.1-3 Prompt identification and treatment is required to reduce the detrimental impact of malnutrition on health and quality of life.4 Studies have shown that up to 76% of readmissions are avoidable.5 By educating Patients on the importance of nutrition,  clinicians can help reduce this number. Read the research studies below to learn how to manage nutrition in post-acute settings and how patients are affected by nutrition.

Background/Summary
With the considerable cost of disease-related malnutrition to individuals and to society there is a need for effective and evidence-based ways of preventing and treating this condition. Systematic reviews and meta-analyses consistently suggest that ready-made, multi-nutrient liquids which may be prescribed can improve energy and nutritional intake, body weight and have a variety of clinical and functional benefits in a number of patient groups. Meta-analyses have repeatedly shown that oral nutritional supplements produce significant reductions in complications (e.g. infections) and mortality, and a recent meta-analysis shows a reduction in hospital admissions (OR 0·56 (95% CI 0·41, 0·77), six randomized controlled trials). Such benefits suggest that the appropriate use of oral nutritional supplements should form an integral part of the management of malnutrition, particularly as there is currently a lack of evidence for alternative oral nutrition strategies (e.g. food fortification and counseling). As with all therapies, compliance to oral nutritional supplements needs to be maximized and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence, substantial cost savings could be made if screening and treatment of malnourished patients was undertaken.

Stratton RJ, Elia M. Encouraging appropriate, evidence-based use of oral nutritional supplements. Proc Nutr Soc 2010; doi:10.1017/S0029665110001977

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1Coats KG et al.. J Am Diet Assoc 1993; 93: 27-33.
2Giner M et al. Nutrition 1996; 12: 23-29.
3Thomas DR et al.Am J Clin Nutr 2002; 75: 308-313.
4Norman K et al. Clin Nutr. 2008; 27: 5-15.
5Medicare Payment Advisory Commission (MedPAC). Report to the Congress: Promoting Greater Efficiency in Medicare. Washington, DC:MedPAC, 2007. Available at: www.medpac.gov/documents/jun07_EntireReport.pdf