Effect of nutritional interventions on discharged older patients: study protocol for a randomized controlled trial

Abstract

Background: During hospitalization, many older patients are at nutritional risk or malnourished, and their nutritional condition is often further impaired during hospitalization. After discharge, a "nutrition gap" often occurs in which the patient does not receive enough nutrition to ensure an optimal recovery. Methods: The study is a randomized controlled study ongoing over 112 days. At discharge, the intervention group receives guidance from a clinical dietitian, and an individualized nutrition plan is made. The dietitian will perform telephone follow-up after 4 and 30 days. It will also be possible for the participant, the participant's relatives, or the participant's municipality to contact the dietitian if nutritional questions arise. At the time of discharge, the intervention group will receive a package containing foods and drinks that will cover their nutritional needs on the first day after discharge. They will also receive a goodie bag containing samples of protein-rich, milk-based drinks. Data are collected on quality of life, appetite, physical function, dietary intake, weight, height, energy and protein needs, and experience of discharge and cooperation with the municipality. Information about nutrition status will be sent to the municipality so that the municipality can take over nutritional treatment. The control group receives a standard treatment. Discussion: This study is the first to combine previously successful single nutritional interventions into a multimodal intervention whose aim is to obtain an effect on patient-related outcomes. We hope that the results will prove beneficial and help to ensure the cross-sector quality of nutritional support to older patients.

Clinical Interventions to Improve Nutritional Care in Older Adults and Patients in Primary Healthcare – A Scoping Review of Current Practices of Health Care Practitioners

“… 17 , 18 , 20 , 22 , 24 , 25 , 27 , 30 The transfer after hospital discharge back to the patient’s home remains a critical period as a “nutritional gap” often inhibits full recovery, resulting in adverse effects on functional ability and rehabilitation. 39 It has been shown recently, that nutritional variables indeed predict chances of returning home and activities of daily living in post-acute geriatric care. 40 Furthermore, a multi-disciplinary transitional program ensuring the continuity of care, that not only improved nutritional status but also associated frailty status and functional ability, showed promising results in community-dwelling older adults.…”

Sensory acceptance of food developed for older adults in different settings

“…Participants were recruited from Oncology, Gastro‐medical/Surgical and Medical Department at Herlev‐Gentofte Hospital from May to December 2018. Participants were part of the study “Effect of Nutritional Efforts on Discharged Elderly Patients” (Munk, Svendsen, Knudsen, Østergaard, & Beck, 2020).…”

“…As part of the study “Effect of Nutritional Efforts on Discharged Elderly Patients” (Munk et al, 2020) the research dietitians at Herlev‐Gentofte hospital gave participants in the intervention group a food package at discharge. The food package was produced by the hospital kitchen and contained a breakfast and four different culinary optimized meals (two main meals, and a combination of two appetizers and/or desserts).…”

Does a 12-Month Transitional Care Model Intervention by Geriatric-Experienced Care Professionals Improve Nutritional Status of Older Patients after Hospital Discharge? A Randomized Controlled Trial

“…Furthermore, a hospital stay is a critical period, which may deteriorate nutritional status and lead to malnutrition at discharge [ 6 ]. Malnutrition in older patients is associated with a higher risk of readmission to hospital, reduced quality of life, increased health care costs, as well as increased risk of morbidity and mortality [ 5 , 7 , 8 ].…”

“…Another considerable problem in older hospitalized patients is a lack of continuity in care and poor coordination of care among health care providers after discharge, which may negatively affect rehabilitation and consequently deteriorate nutritional status [ 8 , 14 , 15 ]. In Germany, in order to assure an appropriate transition process and continuity of care from hospital to home, hospitals are obligated to provide discharge planning shortly before hospital discharge.…”