Individualised dietary counselling for nutritionally at‐risk older patients following discharge from acute hospital to home: a systematic review and meta‐analysis

Munk, T.; Tolstrup, U.; Beck, Anne Marie; Holst, Mette; Rasmussen, Henrik Højgaard; Hovhannisyan, Karen; Thomsen, Thordis

doi:10.1111/jhn.12307

Cited by 57 publications

(65 citation statements)

References 33 publications

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Section: Discussionmentioning

confidence: 99%

“…Further research should explore not only the community resources available, but also the process for referral and barriers to care that occur, especially because quality transition care and interventions initiated in hospital and continued in the community can improve outcomes, including nutritional status (13)(14)(15)(16)(17)(18)(19)(20)(21) . However, communication and continuation of care is a known problem with any transition (22)(23)(24) . This large multicentre cohort study has provided an opportunity to investigate, for the first time, which patient factors are associated with dietetic care post discharge from hospital, yet there are also limitations to this work.…”

Section: Discussionmentioning

confidence: 99%

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Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Keller

Payette

Laporte³

et al. 2017

J Human Nutrition Diet

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Background: Transitions out of hospital can influence recovery. Ideally, malnourished patients should be followed by someone with nutrition expertise, specifically a dietitian, post discharge from hospital. Predictors of dietetic care post discharge are currently unknown. The present study aimed to determine the patient factors independently associated with 30-days post hospital discharge dietetic care for free-living patients who transitioned to the community. Methodology: Nine hundred and twenty-two medical or surgical adult patients were recruited in 16 acute care hospitals in eight Canadian provinces on admission. Eligible patients could speak English or French, provide their written consent, were anticipated to have a hospital stay of ≥2 days and were not considered palliative. Telephone interviews were completed with 747 (81%) participants using a standardised questionnaire to determine whether dietetic care occurred post discharge; 544 patients discharged to the community were included in the multivariate analyses, excluding those who were admitted to nursing homes or rehabilitation facilities. Covariates during and post hospitalisation were collected prospectively and used in logistic regression analyses to determine independent patientlevel predictors. Results: Dietetic care post discharge was reported by 61/544 (11%) of participants and was associated with severe malnutrition [Subjective Global Assessment category C: odd's ratio (OR) 2.43 (1.23-4.83)], weight loss post discharge )], comorbidity [(OR 1.09 (1.02-1.17)] and a dietitian consultation on admission . Conclusions: Dietetic care post discharge occurs in few patients, despite the known high prevalence of malnutrition on admission and discharge. Dietetic care in hospital was the most influential predictor of post-hospital care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Keller

Payette

Laporte³

et al. 2017

J Human Nutrition Diet

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“…Nutrition-focused interventions, such as dietary counselling and oral nutrition supplementation (ONS), have demonstrated success in improving outcomes after discharge (15)(16)(17) . Systematic reviews/meta-analyses have found that dietary counselling and ONS improve energy intake and weight gain, although they have a limited impact on mortality (18)(19)(20)(21)(22)(23)(24) . It is likely that these interventions are valuable components of post-discharge care that includes additional intervention such as discharge planning and care management.…”

Section: Introductionmentioning

confidence: 99%

Malnourished adults’ receipt of hospital discharge nutrition care instructions: a pilot study

Brooks

Vest

Shapero

et al. 2019

J Human Nutrition Diet

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Background Malnutrition remains an important yet under‐recognised problem among hospitalised adults. Although interventions exist aiming to improve nutritional status beyond hospitalisation, few studies examine how often and what type of nutrition care instructions are given at discharge. The present study sought to review nutrition‐focused discharge care provided to malnourished adults. Methods We reviewed the electronic medical record for discharge nutrition care instructions provided to adult patients identified by dietitians as malnourished over a 4‐month period. Results Seventy‐six eligible patients were identified during the study period. More than half of malnutrition cases (64.5%) were attributed to chronic illness. According to electronic medical record documentation, 6.6% received discharge instructions to consume oral nutrition supplements and 30.3% received new or changed prescriptions for vitamins/noncaloric supplements. Almost half of patients (47.4%) received general diet instructions that did not address malnutrition and 44.8% received inappropriate instructions to limit caloric intake. Conclusions A majority of malnourished adult patients receive inappropriate or inadequate nutrition care instructions at the time of discharge. Clinician education and redesign of nutrition care options in the electronic medical record may improve the provision of post‐discharge nutrition care instructions.

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“…Another study involving six patients following similar surgery outlined a need for tailored professional counselling which links with support provided by family and social networks (Washington, 2016). Provision of counselling focusing on individualised dietary advice and intake has been shown to improve outcomes for patients in the acute care setting (Cheung, Pizzola, & Keller, 2013;Munk et al, 2016).…”

Section: E809mentioning

confidence: 99%

Perceptions and experiences of nutritional care following the overwhelming experience of lower extremity amputation: A qualitative study

Jensen

Green

Petersen

et al. 2018

Journal of Clinical Nursing

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Individualised dietary counselling for nutritionally at‐risk older patients following discharge from acute hospital to home: a systematic review and meta‐analysis

Cited by 57 publications

References 33 publications

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Patient‐reported dietetic care post hospital for free‐living patients: a Canadian Malnutrition Task Force Study

Malnourished adults’ receipt of hospital discharge nutrition care instructions: a pilot study

Perceptions and experiences of nutritional care following the overwhelming experience of lower extremity amputation: A qualitative study

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