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Aim The objective of the present study was to determine the most effective method for providing oral nutrition support to hospitalised older adult patients with malnutrition using clinical and patient‐centred measures. Methods The present study involved consecutive assignment of 98 inpatients assessed as malnourished (Subjective Global Assessment B or C) to conventional commercial supplements (traditional, n = 33), MedPass (n = 32, 2 cal/mL supplement delivered 60 mL four times a day at medication rounds) or mid‐meal trolley (n = 33, selective snack trolley offered between meals) for two weeks. Weight change, supplement compliance, energy and protein intake (3‐day food records), quality of life (EQ‐5D), patient satisfaction and cost were evaluated. Results Weight change was similar across the three interventions (mean ± SD): 0.4 ± 3.8% traditional; 1.5 ± 5.8% MedPass; 1.0 ± 3.1% mid‐meal (P = 0.53). Energy and protein intakes (% of requirements) were more often achieved with traditional (107 ± 26, 128 ± 35%) and MedPass (110 ± 28, 126 ± 38%) compared with mid‐meal (85 ± 25, 88 ± 25%) interventions (P = < 0.01). Overall quality‐of‐life ratings (scale 0–100) improved significantly with MedPass (mean change, 12.4 ± 20.9) and mid‐meal (21.1 ± 19.7) interventions, however, did not change with traditional intervention (1.5 ± 18.1) (P = 0.05). Patient satisfaction including sensory qualities (taste, look, temperature, size) and perceived benefit (improved health and recovery) was rated highest for mid‐meal trolley (all P < 0.05). Conclusions Patients achieved recommended intake with supplements (MedPass or traditional), and despite lower cost, higher satisfaction and quality of life with selective mid‐meal trolley did not achieve recommended energy and protein intake. Future research is warranted for implementing a combination of strategies in providing oral nutrition support.

Psychiatry has been limited by historically rooted practices centered primarily on subjective observation. Fields such as oncology have progressed toward data-driven clinical decision-making that combines subjective clinical assessment of symptoms and preferences with biological measures such as genetics, biomarkers, imaging, and integrative physiology to derive quantitative risk scores and decision support. In contrast, psychiatry has just begun to scratch the surface of measurement-based care with validated clinical questionnaires. An opportunity exists to improve modern psychiatric care with novel data streams from digital sensors combined with clinical observation and subjective self-report. The prospect of integrating this complex information with modern computational and analytical methods could advance the field, both in research and clinical practice. Here we discuss this possibility and propose some key priorities to enable these innovations toward improving clinical outcomes in the future.

A policy for the introduction of low-low beds did not appear to reduce falls or falls with injury, although larger studies would be required to determine their effect on fall-related fractures.