An evaluation of the feasibility and validity of a patient‐administered malnutrition universal screening tool (‘<scp>MUST’</scp>) compared to healthcare professional screening in an inflammatory bowel disease (<scp>IBD</scp>) outpatient clinic

Keetarut, Katie; Zacharopoulou-Otapasidou, Stefani; Bloom, Stuart; Majumdar, Anne; Patel, Pinal

doi:10.1111/jhn.12481

Cited by 13 publications

(20 citation statements)

References 30 publications

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“…The excellent results on perceived difficulty are in line with those found in the pilot testing of the Dutch (S‐DI = 0.96), Portuguese (S‐DI = 0.94), Thai (S‐DI = 0.95), and German language versions (S‐DI = 0.91) of the PG‐SGA, demonstrating broad applicability and reproducibility across language versions. Our results on difficulty with completing the PG‐SGA SF also appear to be in line with those reported on the self‐completion of the MUST . In those studies, the proportion of patients rating the MUST as easy or very easy to complete ranged from 92% to 96% …”

Section: Discussionsupporting

confidence: 90%

“…Our results on difficulty with completing the PG‐SGA SF also appear to be in line with those reported on the self‐completion of the MUST . In those studies, the proportion of patients rating the MUST as easy or very easy to complete ranged from 92% to 96% …”

Section: Discussionsupporting

confidence: 90%

“…With questions addressing only BMI and weight loss, the MUST is a screening tool that contains fewer questions than the PG‐SGA SF. Studies on time needed for self‐screening by the MUST reported shorter, similar, and longer durations, that is, 1.29 ± 0.57 minutes, 3.1 ± 1.8 minutes, and 5 ± 19 minutes, respectively. The shortest duration was found in a study in patients (mean age ≈46 years) attending a gastroenterology clinic, using a 5‐step procedure, with a digital tool equivalent to the first 2 steps of the MUST, that is, BMI and weight loss.…”

Section: Discussionmentioning

confidence: 94%

“…Our results on difficulty with completing the PG-SGA SF also appear to be in line with those reported on the self-completion of the MUST. [24][25][26]30,31 In those studies, the proportion of patients rating the MUST as easy or very easy to complete ranged from 92% 25 to 96%. 26 The findings of the current study demonstrate that after self-completion of the PG-SGA SF, patient awareness on risk for malnutrition may increase.…”

Section: Discussionmentioning

confidence: 99%

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Self‐Completion of the Patient‐Generated Subjective Global Assessment Short Form Is Feasible and Is Associated With Increased Awareness on Malnutrition Risk in Patients With Head and Neck Cancer

et al. 2019

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Background We aimed to assess feasibility of self‐completion of the Patient‐Generated Subjective Global Assessment Short Form (PG‐SGA SF) by head and neck cancer patients, and to assess self‐reported increased awareness regarding malnutrition risk after self‐completion. Methods Participants were randomized to complete the PG‐SGA SF by paper or app. Feasibility was assessed by time needed to complete the PG‐SGA SF, perceived difficulty, and help needed during completion. Participants were asked if they knew what malnutrition was (yes/no) and if they could define “malnutrition.” They were also asked 9 questions on whether they perceived increased awareness of malnutrition risk after having completed the PG‐SGA SF and 2 on their intention to change lifestyle habits. Results Of all participants (n = 59; 65.9 ± 12.6 years; 73% male), 55% completed the PG‐SGA SF paper version and 46% the Pt‐Global app. Median time needed for self‐completion of the PG‐SGA SF was 2 minutes 41 seconds (interquartile range: 1 minute 49 seconds–3 minutes 50 seconds). Forty‐eight percent needed help with completion, indicating acceptable feasibility. Participants who completed the Pt‐Global app needed help significantly more often (66%; 21/32) than those who completed the PG‐SGA SF paper version (26%; 7/27) (P = 0.005). All difficulty scores were excellent. For 7/9 questions on malnutrition risk awareness, >50% of the participants answered positively. Conclusion The results of this study show that self‐completion of the PG‐SGA SF by head and neck cancer patients is feasible and that awareness regarding malnutrition risk may increase after completing the PG‐SGA SF.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Self‐Completion of the Patient‐Generated Subjective Global Assessment Short Form Is Feasible and Is Associated With Increased Awareness on Malnutrition Risk in Patients With Head and Neck Cancer

et al. 2019

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“…Further research into the use of patient-led versions of malnutrition screens would also be of interest. Although the studies evaluating patient-led NSTs did not meet eligibility criteria for this review, the patient-led MUST has correlated with a practitioner-led MUST in IBD[45,46] and is in keeping with the utility of these screens in other chronic disease populations[47,48]. As a direct translation to clinical practice, the signal that NSTs predict clinical outcomes supports their importance.…”

Section: Discussionmentioning

confidence: 95%

Systematic review of nutrition screening and assessment in inflammatory bowel disease

Ney

Eslamparast

et al. 2019

WJG

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BACKGROUND Malnutrition is prevalent in inflammatory bowel disease (IBD). Multiple nutrition screening (NST) and assessment tools (NAT) have been developed for general populations, but the evidence in patients with IBD remains unclear. AIM To systematically review the prevalence of abnormalities on NSTs and NATs, whether NSTs are associated with NATs, and whether they predict clinical outcomes in patients with IBD. METHODS Comprehensive searches performed in Medline, CINAHL Plus and PubMed. Included: English language studies correlating NSTs with NATs or NSTs/NATs with clinical outcomes in IBD. Excluded: Review articles/case studies; use of body mass index/laboratory values as sole NST/NAT; age < 16. RESULTS Of 16 studies and 1618 patients were included, 72% Crohn’s disease and 28% ulcerative colitis. Four NSTs (the Malnutrition Universal Screening Tool, Malnutrition Inflammation Risk Tool (MIRT), Saskatchewan Inflammatory Bowel Disease Nutrition Risk Tool (SaskIBD-NRT) and Nutrition Risk Screening 2002 (NRS-2002) were significantly associated with nutritional assessment measures of sarcopenia and the Subjective Global Assessment (SGA). Three NSTs (MIRT, NRS-2002 and Nutritional Risk Index) were associated with clinical outcomes including hospitalizations, need for surgery, disease flares, and length of stay (LOS). Sarcopenia was the most commonly evaluated NAT associated with outcomes including the need for surgery and post-operative complications. The SGA was not associated with clinical outcomes aside from LOS. CONCLUSION There is limited evidence correlating NSTs, NATs and clinical outcomes in IBD. Although studies support the association of NSTs/NATs with relevant outcomes, the heterogeneity calls for further studies before an optimal tool can be recommended. The NRS-2002, measures of sarcopenia and developments of novel NSTs/NATs, such as the MIRT, represent key, clinically-relevant areas for future exploration.

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Food-related quality of life is impaired in inflammatory bowel disease and associated with reduced intake of key nutrients

Whelan

Murrells

Morgan

et al. 2021

The American Journal of Clinical Nutrition

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Background Inflammatory bowel disease (IBD) may impact the extent to which food, eating, and drinking bring satisfaction and enjoyment to peoples’ lives, and this may impact dietary intake. The prevalence of an impaired food-related quality of life (FR-QoL), its associated factors, and its impact on diet have not been explored. Objectives To measure the prevalence and nature of the burden of impaired FR-QoL in people with IBD, the factors associated with these, and their associations with nutrient intake. Methods We recruited 1576 outpatients with IBD (≥16 years old) in person from 7 IBD centers across the United Kingdom. Patients completed validated questionnaires to measure their FR-QoL, quality of life (QoL), distress, fatigue, anxiety, and depression. Dietary intake was recorded using the European Prospective Investigation into Cancer FFQ. A health professional recorded disease activity, Montreal classification, blood results, BMI, and malnutrition risk. FR-QoL was regressed onto explanatory variables using univariable and multivariable analyses. Results Data from 1221 patients were available (77.4% response; Crohn's disease, 65%; ulcerative colitis, 35%). The FR-QoL mean (± SD) score was 80.8 ± 26.9, with wide ranges (minimum, 29; maximum, 145). Following multivariable regression, the strongest associations with FR-QoL were the number of recent disease flares (5 flares β = −12.7; P < 0.001), the IBD-specific QoL (β = 0.33; P < 0.001), and IBD-related distress (β = −0.26; P < 0.001). Patients with poorer FR-QoL had lower intakes of fiber (nonstarch polysaccharide; Q1 to Q5 difference = 2.1 g/d; 95% CI: 0.4–3.8; P = 0.048), calcium (192.6 mg/d; 95% CI: 112.5–272.6; P < 0.001), phosphorus (167 mg/d; 95% CI: 58–276; P = 0.041), and magnesium (34.4 mg/d; 95% CI: 9.3–59.4; P = 0.041). Conclusions Impaired FR-QoL is prevalent in IBD and is associated with recurrent disease flares, a reduced IBD-specific QoL, and greater IBD-related distress. A poorer FR-QoL was associated with lower intakes of key nutrients of importance to IBD, including those relating to gut health and bone mineralization.

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An evaluation of the feasibility and validity of a patient‐administered malnutrition universal screening tool (‘MUST’) compared to healthcare professional screening in an inflammatory bowel disease (IBD) outpatient clinic

Cited by 13 publications

References 30 publications

Self‐Completion of the Patient‐Generated Subjective Global Assessment Short Form Is Feasible and Is Associated With Increased Awareness on Malnutrition Risk in Patients With Head and Neck Cancer

Self‐Completion of the Patient‐Generated Subjective Global Assessment Short Form Is Feasible and Is Associated With Increased Awareness on Malnutrition Risk in Patients With Head and Neck Cancer

Systematic review of nutrition screening and assessment in inflammatory bowel disease

Food-related quality of life is impaired in inflammatory bowel disease and associated with reduced intake of key nutrients

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