Efficacy of a Medication Pass Supplement Program in Long-Term Care Compared to a Traditional System

Welch, Patricia; Porter, LD Janet; Endres, Jeannette

doi:10.1300/j052v22n03_02

Cited by 16 publications

(17 citation statements)

References 14 publications

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“…Our research group has reported that only 58% of patients prescribed NAM actually received it . However, when patients did receive NAM correctly as prescribed, compliance was excellent (consumption rates of 96%), as is consistent with previous literature …”

Section: Introductionsupporting

confidence: 91%

Qualitative study of patients and health‐care professionals' views on the efficacy of the nutrition as medication oral nutrition supplement program

Lambert

Potter

Lonergan

et al. 2015

Nutrition & Dietetics

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Aim The use of concentrated oral nutrition supplements dispensed in small volumes throughout the day at medication rounds is a common nutrition support strategy. Often termed 'Nutrition as Medication' or NAM, it is associated with excellent rates of patient consumption. However, administration of NAM has been described as suboptimal. The aim of the present study was to identify and explore factors influencing the efficacy of the NAM program from a qualitative perspective. This included exploring issues relating to knowledge, administration and patient consumption from a patient and health professional perspective. Methods Semistructured interviews with patients (n = 7) and eight focus groups with nursing, medical, pharmacy and dietetic staff (n = 63) were conducted. Interviews were conducted in the workplace and were recorded and transcribed verbatim. Data were analysed from a realist theoretical position using the thematic framework approach. Results Five themes were identified that impact on the efficacy of the NAM program. These include the need for clear role delineation among health professionals regarding responsibility for each aspect of NAM. Other themes that emerged included misconceptions about the importance and relevance of the treatment; perceptions of poor palatability and issues associated with the logistics of providing the supplements within the hospital setting. Conclusions Dietitians should be aware that there are a range of factors that influence the efficacy of the NAM strategy, including the knowledge and values of individual health professional staff. In addition, increased awareness is required by dietitians regarding the structural barriers to administration and receiving of NAM at the ward level. AbstractAim: The use of concentrated oral nutrition supplements dispensed in small volumes throughout the day at medication rounds is a common nutrition support strategy. Often termed 'Nutrition as Medication' or NAM, it is associated with excellent rates of patient consumption. However, administration of NAM has been described as suboptimal. The aim of this study was to identify and explore factors influencing the efficacy of the NAM program from a qualitative perspective. This included exploring issues relating to knowledge, administration and patient consumption from a patient and health professional perspective.Methods: Semi structured interviews with patients (n=7) and eight focus groups with nursing, medical, pharmacy and dietetic staff (n=63) were conducted.Interviews were conducted in the workplace and were recorded and transcribed verbatim. Data were analysed from a realist theoretical position using the thematic Framework Approach.Results: Five themes were identified that impact on the efficacy of the NAM program. These include the need for clear role delineation amongst health professionals regarding responsibility for each aspect of NAM. Other themes that emerged included misconceptions about the importance and relevance of the treatment; perceptions of poor palatability a...

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Section: Introductionsupporting

confidence: 91%

Qualitative study of patients and health‐care professionals' views on the efficacy of the nutrition as medication oral nutrition supplement program

Lambert

Potter

Lonergan

et al. 2015

Nutrition & Dietetics

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show abstract

“…One innovative strategy is the concept of prescribing a calorically dense ONS on the medication chart in small volumes frequently throughout the day . Commonly known as either ‘Med Pass’ or Nutrition as Medication (or NAM), this program's efficacy in improving energy and protein intake is well described . Despite clear evidence of benefits associated with NAM and the existence of routine clinical guidelines to implement NAM, we hypothesise that the deficit in practice may lie in the implementation of NAM.…”

Section: Introductionmentioning

confidence: 97%

Efficacy of nutrition as medication in malnourished hospitalised patients is strongly influenced by environmental factors

Lambert

Potter

Lonergan

et al. 2013

Nutrition & Dietetics

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Aim:To evaluate the use of Nutrition as Medication (NAM) as a dietary intervention strategy in a sample of malnourished renal and geriatric hospital inpatients. Methods: In the study period of 1 July to 30 August 2009, patients admitted to the acute renal or geriatric wards of a large general hospital and assessed as malnourished or at risk of malnutrition and suitable to commence NAM were eligible for inclusion in this pilot clinical cohort study. Medication charts of the study patients were audited and opportunistic observations of patients receiving NAM were conducted. Comparisons of receival and refusal rates of NAM between chart audits and observations were made. Environmental influences on administration, delivery and consumption were noted. Results: Eighteen patients were included in the study. Audits of their medication charts indicated 943 doses of NAM were prescribed in the study period. The receival rate of NAM was 66.4% and refusal rate was 8.9%. Forty-eight incident observations of the NAM process were conducted noting a receival rate was 58.3% and refusal rate of 3.6%. Environmental factors such as adequate supplies and location of NAM stock influenced the receival rate of NAM. Conclusions: In the present study, receival of NAM by renal and geriatric inpatients was suboptimal. The strategy was strongly influenced by environmental factors such as nurse administration of NAM. However, when NAM was received as prescribed, refusal was rare. Further exploration is warranted of NAM receival and consumption in other malnourished groups and of the environmental factors influencing NAM delivery.

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“…This resulted in more weight gain than with ONS drinks in a study of long‐term residential home residents with cognitive impairment (Welch et al . ). Therefore, other factors are essential to consider when commencing patients and residents on supplement drinks.…”

Section: Discussionmentioning

confidence: 97%

Impact of serving method on the consumption of nutritional supplement drinks: randomized trial in older adults with cognitive impairment

Allen

Methven

Gosney

2013

Journal of Advanced Nursing

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Efficacy of a Medication Pass Supplement Program in Long-Term Care Compared to a Traditional System

Cited by 16 publications

References 14 publications

Qualitative study of patients and health‐care professionals' views on the efficacy of the nutrition as medication oral nutrition supplement program

Qualitative study of patients and health‐care professionals' views on the efficacy of the nutrition as medication oral nutrition supplement program

Efficacy of nutrition as medication in malnourished hospitalised patients is strongly influenced by environmental factors

Impact of serving method on the consumption of nutritional supplement drinks: randomized trial in older adults with cognitive impairment

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