Home Artificial Nutrition in Switzerland: An Epidemiological Survey from 2005 to 2009

Abstract

Background and Aims: Home artificial nutrition (HAN), including oral nutritional supplements (ONS) and enteral (HEN) and parenteral (HPN) nutrition, is an established, important treatment for malnourished patients. The aim of this study was to analyze the epidemiological data of patients on HAN in Switzerland. Methods: This retrospective study recorded all new cases of HAN in Switzerland from January 2005 to December 2009. Results: A total of 12,917 cases were recorded: 6,731 (52%) males and 6,186 (48%) females, with a mean age of 65.0 ± 17.6 years. The number of patients on ONS was 7,827 (57.4%), on HEN 3,966 (39.4%) and on HPN 433 (3.2%). The most common underlying disease category was neoplasms (6,519, 50.7%). The number of patients on ONS increased from 57.0% (n = 1,252) to 60.8% (n = 2,039), and on HPN from 2.1% (n = 45) to 4.0% (n = 134) between 2005 and 2009. Conclusions: This first analysis of the large-scale Swiss registry of HAN shows that approximately half of the patients received ONS, whereas HPN was rarely delivered. The frequency of ONS and HPN increased from the year 2005 to 2009. In accordance with previous European studies, malignant tumors were by far the most frequent indication for HAN.

Changes in Home Parenteral Nutrition Practice Based on the Canadian Home Parenteral Nutrition Patient Registry

“…Our results are similar to those of HPN programs in other countries. Oncology patients represented the largest percentage of HPN patients in studies from Spain (49.5%), 5 Switzerland (57.4%), 13 and the United States (42%) 14 . The increasing number of cancer patients in the HPN programs might contribute to the more frequent use of PICC in some centers where chemotherapy might be delivered via this route.…”

When Is Parenteral Nutrition Appropriate?

“…Wide variation exists in the data reported regarding the primary medical condition of patients requiring HPN. In many countries, the largest diagnostic category of HPN recipients consists of patients with active cancer, whereas Crohn's disease, short bowel syndrome, and surgical complications are more common reasons for HPN in others 5 . ‐ 8 A downward trend in the use of HPN for Crohn's disease may reflect advances in the treatment of the disease, but more research is needed to confirm this premise 5 …”

Management of Home Parenteral Nutrition: A Prospective Multicenter Observational Study

“…The proportion of HPN patients with oncological tumors has increased over the past years in Europe [28] . Previous Swiss data about the indications for home artificial nutrition demonstrated that neoplasms were the most frequent underlying disease (51%), diseases of the digestive system on the second place (10.4%) and diseases of the nervous system in third place (9.6%) [8] . In our study, there were no patients with underlying neurological disorders.…”

“…The most common indications for long-term HPN in Europe are Crohn's disease, mesenteric vascular disease, cancer and radiation enteritis [7] . Other more recent studies confirm that malignancy is the single most common indication for HPN [8,9] .…”

“…Shaw et al [8] performed a first retrospective epidemiological analysis of patients with home artificial nutrition in Switzerland, based on data provided by the leading national insurance provider. Over the 5-year analysis period, from 2005 to 2009, 433 HPN patients were recorded, showing increasing frequency of HPN.…”