Malnutrition in care homes: a feasibility study

Mise à jour : Il y a 4 ans
Référence : ISRCTN38047922

Femme et Homme

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Extrait

Background and study aims Malnutrition increases risk of disease, delays recovery from illness and reduces quality of life. Care home residents are especially vulnerable, with an estimated 42% at risk. There is no agreed nutritional treatment for malnutrition. Techniques include food-based intervention and/or the use of prescribed oral nutritional supplements (ONS). It is unclear whether conventional food improves outcomes but there is growing evidence to support use of ONS. However, as conventional food is less expensive, some NHS trusts have developed stricter prescribing guidance to encourage 'food-first'. Care home residents are under-represented in research and evidence to guide best nutritional care is lacking. This is an initial study to compare three approaches within an elderly care home population: food-based intervention, prescribed ONS intervention and standard care for malnutrition. The results will help design a larger study. Who can participate? Care homes that have received dietitian training. What does the study involve? The six care homes that have been identified will be randomly allocated to one of three groups: food-based intervention, ONS intervention or standard care. Residents who are malnourished or at risk of malnutrition will be eligible to participate. The Dietitian researcher will deliver the interventions, aiming to increase participant intake by 600kcal and 20-25g protein daily. Care homes allocated to standard care will continue to provide energy-enriched diets, in line with local guidance. What are the possible benefits and risks of participating? We consider this study to be low risk. The nutritional interventions being evaluated are well stablished and are currently in use to treat malnutrition in the care home population. Given their wide usage, unexpected adverse events are highly unlikely. Expected adverse events include the possibility of diarrhoea, bloating, nausea or satiety (gastrointestinal symptoms) on initiating ONS or a change in diet. Expected adverse events will be minimised as the dietary interventions will be delivered as per usual, standard practice to those that require them, by and under the control of a Registered Nutrition Support Dietitian. If any of the residents within the care homes allocated to the standard care home intervention experience a decline of nutritional status, they will be provided with dietetic intervention (food-based or ONS), after 6 weeks of standard care. This follows local and national best practice guidelines and current, standard care within the local community setting. All of the care home residents that receive the allocated nutritional intervention will be at moderate or high risk of malnutrition. They may benefit from any of the nutritional interventions, if they prove to be effective at improving energy intake and anthropometry parameters. The information we get from this study will be used for a future larger study, which may help us to provide improved nutritional care for future care home residents with malnutrition. The findings will be shared with the local care home community. Where is the study run from? The study is being run from 6 privately run care homes (3 nursing and 3 residential) in Solihull Community (West Midlands). When is the study starting and how long is it expected to run for? December 2013 to September 2014. Who is funding the study? Investigator initiated and funded as part of Heart of England NHS Foundation Trust (UK) Who is the main contact? Miss Ruth Stow [email protected]


Critère d'inclusion

  • Protein care energy malnutrition (PEM) within elderly care home residents

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