Do doctors know how much nutrition patients need—a survey from Germany?

Abstract

For the diagnosis, prevention and therapy of malnutrition, it is important to estimate the energy and fluid requirements of an individual patient. To our knowledge, it is unknown how accurately medical doctors can estimate the energy and fluid requirements of patients in a clinical routine situation. Hence, we conducted the following survey. A written face-to-face survey about the energy and fluid requirements of and tube feeding and fluid recommendations for a typical patient was performed with 179 medical doctors. An estimation error of >15% was defined as relevant. The results revealed substantial variations in estimating the energy and fluid needs of the patient. A total of 25% of the participants underestimated the energy requirements, and 47% of the participants underestimated the fluid requirements. In addition, 68% of the participants recommended a daily dose of tube feeding that was <85% of the reference value. A substantial proportion of medical doctors show a lack of knowledge concerning energy and fluid requirements, which demonstrates a need for better medical education with regard to nutrition.

Clinical Nutrition in Portuguese Gastroenterology Departments: A Multicentric Study

“…Standardized and structured core nutrition training would be of value to increase expertise among practitioners. The scarce information on nutrition is also identified in many European countries, where training programs for medical and surgical specialties lack formal nutrition support training/education [ 23 ], resulting in an incapacity to assess patients’ nutritional requirements properly [ 24 , 25 , 26 ]. In addition, only two departments developed research in nutrition, a low number given the recognized importance of this field and the potential impact on patient comorbidities and mortality [ 6 ].…”

Supportive Ernährungstherapie für onkologische PatientInnen während der Behandlungsphase

“…Die Auswirkung dieses Wissensdefizits wird durch eine Befragung unter deutschen ÄrztInnen klar. Hier konnten Wirth et al zeigen, dass der Energiebedarf der PatientInnen von ÄrztInnen meist eher unter-als überschätzt wird [41]. Deshalb ist es wichtig, dass Ärz-tInnen und weitere Mitglieder des Behandlungsteams die Patien-tInnen entweder an qualifizierte ErnährungstherapeutInnen verweisen (Info) und/oder auf evidenzbasierte Informationsquellen aufmerksam machen, vor allem, um einer Mangelernährung vorzubeugen [42,43] (▶tab.…”

“…Wo es den ÄrztInnen an Wissen mangelt, wird der Wert spezialisierter ErnährungsberaterInnen als Teil des multidisziplinären Teams noch deutlicher. Es ist daher von entscheidender Bedeutung, dass OnkologInnen und Mitglieder der multidisziplinären Betreuungsteams ihren eigenen Tätigkeitsbereich im Hinblick auf die medizinische Ernährungstherapie kennen und dass angemessene Überweisungsverfahren zur Standardpraxis gehören [24,34,40,41,44]. Da die Möglichkeit einer qualifizierten Ernährungstherapie für onkologische PatientInnen in Deutschland noch nicht ausreichend vorhanden ist, können PatientInnen immer an die in ▶tab.…”

Australian and New Zealand Medical Students’ Attitudes and Confidence towards Providing Nutrition Care in Practice

“…Primary care doctors require nutrition knowledge and skills to enable them to provide nutrition care to patients, or to identify patients for whom specialist dietetic advice is required. The international literature suggests that doctors lack nutrition knowledge and skills to provide high quality nutrition care [11][12][13]. The barriers that doctors face in providing nutrition care include a lack of time and reimbursement, insufficient resources, inadequate nutrition education and limited confidence to deliver this care [14].…”