Home enteral nutrition reduces complications, length of stay, and health care costs: results from a multicenter study

Kłęk, Stanisław; Hermanowicz, Adam; Dziwiszek, Grzegorz; Matysiak, Konrad; Szczepanek, Kinga; Szybiński, P.; Gałaś, Aleksander

doi:10.3945/ajcn.113.082842

Cited by 70 publications

(77 citation statements)

References 32 publications

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“…The infusion of enteral diets by thin caliber nasogastric catheters (French 10 to 12) is common in home care in Brazil, unlike other studies in which gastrostomy 6 or the oro-gastric position was more common 5 . Homemade diets usually have higher viscosity than industrialized ones.…”

Section: Resultsmentioning

confidence: 98%

“…Home-based ENT has a satisfactory cost-benefit ratio as it reduces the risk of infection by avoiding prolonged hospital stays, and is cheaper than hospital enteral therapy 6 . It also improves nutritional status 5,6 and allows coexistence with the family, favoring comfort and quality of life 7 , contributing to an adequate and healthy diet.…”

Section: Introductionmentioning

confidence: 99%

“…It also improves nutritional status 5,6 and allows coexistence with the family, favoring comfort and quality of life 7 , contributing to an adequate and healthy diet.…”

Section: Introductionmentioning

confidence: 99%

“…Such individuals are susceptible to malnutrition and sarcopenia, especially due to the permanent presence of dysphagia, with the inability to meet nutritional needs via the oral route 2,5 . In such cases, one treatment approach is home-based enteral nutritional therapy (ENT) 2,5,6 .…”

Section: Introductionmentioning

confidence: 99%

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Development of enteral homemade diets for elderly persons receiving home care and analysis of macro and micronutrient composition

Jansen

Generoso

Guedes

et al. 2017

Rev. bras. geriatr. gerontol.

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Objective: the development and analysis of the macro and micronutrient composition of homemade enteral diets. Method: A standard homemade enteral diet was developed at three caloric concentrations -1500, 1800 and 2100 Kcal. After preparation and testing of viscosity, stability, odor and color, plus evaluation of cost, the chemical composition of the nutrients of the diets were analytically determined. Folic acid, vitamin D and vitamin B12 values were calculated using chemical composition tables. The results were compared with recommended nutritional standards for the elderly. Result: The diets exhibited normal macronutrient distribution. The 1500 caloric level presented some mineral and vitamin deficiencies. Suitable values were obtained at the other caloric levels for all minerals except magnesium. There were appropriate levels of all the vitamins in the 2100 Kcal diet, while vitamin E, D and B6 levels were below the recommended dietary allowances in the 1800 Kcal diet. Conclusion: The standard homemade enteral diets studied can contribute to the food and nutritional safety of elderly persons undergoing home care, if all are supplemented with magnesium and the 1800 Kcal diet is supplemented with vitamin E, D and B6. The 1500 Kcal diet was not nutritionally safe in terms of micronutrients.

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Section: Resultsmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

“…It also improves nutritional status 5,6 and allows coexistence with the family, favoring comfort and quality of life 7 , contributing to an adequate and healthy diet.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Development of enteral homemade diets for elderly persons receiving home care and analysis of macro and micronutrient composition

Jansen

Generoso

Guedes

et al. 2017

Rev. bras. geriatr. gerontol.

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“…Impulsado por estos avances, el uso de la NED ha ido aumentando en las últimas décadas hasta alcanzar una prevalencia de 67,1 casos por cada millón de habitantes, según el registro NADYA (5), aunque la tasa es superior según otras estimaciones (6,7). Este aumento es debido a que la NED permite a los pacientes acortar las estancias hospitalarias, reducir los costes hospitalarios asociados (8,9) y mejorar su calidad de vida (10,11).…”

Section: Introductionunclassified

Preferencias por los atributos de la nutrición enteral domiciliaria (NED) en España. ¿Conocen los cuidadores las preferencias de los pacientes?

et al. 2017

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Conflicto de intereses: El estudio ha sido financiado por Nestlé Health Sciences. El financiador no ha influido en el análisis de los datos, en la preparación del manuscrito ni en la decisión de publicarlo.Preferencias por los atributos de la nutrición enteral domiciliaria (NED) en España. ¿Conocen los cuidadores las preferencias de los pacientes?Preferences for the attributes of home enteral nutrition (HEN) ResumenIntroducción: establecer una nutrición enteral domiciliaria (NED) adaptada a las necesidades y preferencias del paciente puede mejorar la calidad de vida y la adherencia, contribuyendo a una mayor eficiencia del tratamiento, mejor pronóstico y reducción de costes. En muchos casos los pacientes requieren ayuda total o parcial de cuidadores, por lo que es importante evaluar hasta qué punto estos conocen sus preferencias. Objetivos: explorar las preferencias de los pacientes por las características de la NED en España, y la concordancia entre paciente y cuidador. Métodos: estudio observacional, transversal, basado en la metodología del experimento de elección discreta. Se presentaron ocho escenarios de elección generados a partir de seis atributos con dos niveles, y un cuestionario ad hoc de importancia y satisfacción con la NED. Se estimó la importancia relativa (IR) de cada atributo y la concordancia paciente-cuidador en todas las cuestiones. Resultados: participaron 148 pacientes; en 77 casos cumplimentaron las cuestiones los pacientes y sus cuidadores. Los atributos más importantes (IR) en la NED fueron adaptabilidad a comorbilidades (33%), tolerabilidad (33%), aporte de nutrientes y calorías (26%) y características del envase (8%). Los pacientes mostraron un elevado grado de satisfacción con la asistencia recibida. Se encontró concordancia paciente-cuidador en todas las cuestiones, siendo esta de moderada a buena. Conclusiones: según los pacientes, el producto para NED ideal se adapta a las comorbilidades, es fácilmente tolerable, y aporta los nutrientes y calorías necesarios, con un envase de fácil manejo. Los cuidadores conocen bien las preferencias del paciente. Key words:Home enteral nutrition. Discrete choice experiment. Patients preferences. Caregivers. Concordance. AbstractIntroduction: Establishing a home enteral nutrition (HEN) that is adapted to the patient's needs and preferences can improve their quality of life and adherence, contributing to a higher treatment efficiency, better prognosis and cost reduction. As in most cases, patients need total or partial help from their caregivers, and there is a need for evaluating how well do caregivers know their patients' priorities. Objectives: Exploring patients' preferences for HEN characteristics in Spain, and the concordance between patients and caregivers. Methods: A cross-sectional observational study based on the discrete choice experiment methodology. A set of eight choice scenarios generated from six attributes with two levels each was presented along with an ad hoc questionnaire on the importance and satisfaction with HEN. The relati...

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Home enteral nutrition: Use of photo‐elicitation to capture patient and caregiver experiences

Asiedu

Carroll

Griffin

et al. 2018

Health Science Reports

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BackgroundDespite the importance of home enteral nutrition (HEN), there is a lack of understanding within the medical and general community of how HEN impacts the lives of patients and caregivers. Using a theoretical orientation that attends to the materiality of both everyday and medical objects, we explored patients' and family caregivers' everyday experiences of administering feeds during HEN.MethodsUsing the photo‐elicitation interviewing method, patients on HEN and their family caregivers were asked to take up to 10 photographs to portray material items and activities that they considered foundational to HEN. They subsequently narrated their experiences and the participant‐generated photographs in an interview. Participant‐generated photographs (126) and accompanying narratives were analyzed using layered analysis, and results were theorized with attention to both social and material significance of HEN.ResultsPatients and caregivers detailed overcoming misconceptions of HEN, and through their use of photographs, they conveyed their expertise in developing their own HEN feeding systems and practices, that used both the material artifacts provided by the hospital (the tube, syringe, and formula) as well as everyday material items found in the patient's home. More than this, photographs and patient narratives depicted intimate involvement of patients' families in tube feeding. This yielded a more comprehensive understanding of the material and experiential realities of HEN.ConclusionHome enteral nutrition was found to be a shared familial experience, that in addition to requiring medical equipment also incorporated ordinary material artifacts within the social setting of the home and family life. To more accurately convey the material, experiential, and social realities of HEN to future patients, our findings underscore the importance of drawing on both visual and textual forms of patient‐produced information in the development of HEN patient educational materials.

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Home enteral nutrition reduces complications, length of stay, and health care costs: results from a multicenter study

Abstract: The study showed that HEN improves clinical outcomes and decreases health care costs. It was impossible, however, to determine precisely which factor mattered more: the artificial diet itself or the introduction of complex care.

Cited by 70 publications

References 32 publications

Development of enteral homemade diets for elderly persons receiving home care and analysis of macro and micronutrient composition

Development of enteral homemade diets for elderly persons receiving home care and analysis of macro and micronutrient composition

Preferencias por los atributos de la nutrición enteral domiciliaria (NED) en España. ¿Conocen los cuidadores las preferencias de los pacientes?

Home enteral nutrition: Use of photo‐elicitation to capture patient and caregiver experiences

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