Pp097-Mon Oral Nutritional Supplement (Ons) Improved Nutritional Status in Malnourished Patients Receiving Hip Fracture Surgery

Luo, Menghua; Golybev, G.; Klyukvin, I. Yu.; Резник, Л. Б.; Kuropatkin, G. V.; Voss, Anne Coble

doi:10.1016/s1744-1161(11)70389-1

Cited by 3 publications

(12 citation statements)

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“…Pairwise meta-analyses were undertaken to assess the effects of ONS compared with SC on the outcomes of interest in this review. Ten studies [53][54][55][56][57][67][68][69]71,74 were included in the pairwise meta-analyses (see Appendix 10 for reasons why studies/outcomes were excluded from the meta-analysis). The metaanalysis results are presented alongside a narrative synthesis of the outcomes that were unable to be pooled.…”

Section: Summary Of Effectiveness Resultsmentioning

confidence: 99%

“…living along, married). Luo et al 74 did not describe living arrangements. Tidermark et al 69 noted that their participants lived at home and were non-institutionalised but did not provide any further details.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The type of ONS used and the comparisons varied across the studies. Six studies 54,55,57,68,71,74 compared ONS with usual care or SC in one of their arms, and two 53,72 compared ONS with dietary counselling or advice. The remaining studies contained a number of comparisons; these are detailed in Table 2.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Five studies 54,55,57,67,72 were rated as unclear. Five studies 53,56,68,69,74 were assessed as being at low risk of bias for this domain.…”

Section: Allocation Concealmentmentioning

confidence: 99%

“…Three studies 57,71,74 reported data on the effect of ONS compared with SC on ADL, which refers to the ability to perform everyday tasks (or 'activities of daily living') as a measure of disability or level of physical functioning. One study 71 measured ADL using the Barthel Index, which comprises 10 items in relation to which participants are assigned points, with a higher score indicating an increased ability to perform a task.…”

Section: Activities Of Daily Livingmentioning

confidence: 99%

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Oral nutritional interventions in frail older people who are malnourished or at risk of malnutrition: a systematic review

Thomson

Rice

Arisa

et al. 2022

Health Technol Assess

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Background Malnutrition worsens the health of frail older adults. Current treatments for malnutrition may include prescribed oral nutritional supplements, which are multinutrient products containing macronutrients and micronutrients. Objective To assess the effectiveness and cost-effectiveness of oral nutritional supplements (with or without other dietary interventions) in frail older people who are malnourished or at risk of malnutrition. Data sources MEDLINE, EMBASE, Cochrane Library, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and grey literature were searched from inception to 13 September 2021. Review methods A systematic review and meta-analysis was conducted to evaluate the effectiveness and cost-effectiveness of oral nutritional supplements in frail older people (aged ≥ 65 years) who are malnourished or at risk of malnutrition (defined as undernutrition as per National Institute for Health and Care Excellence guidelines). Meta-analysis and network meta-analysis were undertaken, where feasible, along with a narrative synthesis. A cost-effectiveness review was reported narratively. A de novo model was developed using effectiveness evidence identified in the systematic review to estimate the cost-effectiveness of oral nutritional supplements. Results Eleven studies (n = 822 participants) were included in the effectiveness review, six of which were fully or partly funded by industry. Meta-analyses suggested positive effects of oral nutritional supplements compared with standard care for energy intake (kcal) (standardised mean difference 1.02, 95% confidence interval 0.15 to 1.88; very low quality evidence) and poor mobility (mean difference 0.03, p < 0.00001, 95% confidence interval 0.02 to 0.04; very low quality evidence) but no evidence of an effect for body weight (mean difference 1.31, 95% confidence interval –0.05 to 2.66; very low quality evidence) and body mass index (mean difference 0.54, 95% confidence interval –0.03 to 1.11; very low quality evidence). Pooled results for other outcomes were statistically non-significant. There was mixed narrative evidence regarding the effect of oral nutritional supplements on quality of life. Network meta-analysis could be conducted only for body weight and grip strength; there was evidence of an effect for oral nutritional supplements compared with standard care for body weight only. Study quality was mixed; the randomisation method was typically poorly reported. One economic evaluation, in a care home setting, was included. This was a well-conducted study showing that oral nutritional supplements could be cost-effective. Cost-effectiveness analysis suggested that oral nutritional supplements may only be cost-effective for people with lower body mass index (< 21 kg/m2) using cheaper oral nutritional supplements products that require minimal staff time to administer. Limitations The review scope was narrow in focus as few primary studies used frailty measures (or our proxy criteria). This resulted in only 11 included studies. The small evidence base and varied quality of evidence meant that it was not possible to determine accurate estimates of the effectiveness or cost-effectiveness of oral nutritional supplements. Furthermore, only English-language publications were considered. Conclusions Overall, the review found little evidence of oral nutritional supplements having significant effects on reducing malnutrition or its adverse outcomes in frail older adults. Future work Future research should focus on independent, high-quality, adequately powered studies to investigate oral nutritional supplements alongside other nutritional interventions, with longer-term follow-up and detailed analysis of determinants, intervention components and cost-effectiveness. Study registration This study is registered as PROSPERO CRD42020170906. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 26, No. 51. See the NIHR Journals Library website for further project information.

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Section: Summary Of Effectiveness Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Five studies 54,55,57,67,72 were rated as unclear. Five studies 53,56,68,69,74 were assessed as being at low risk of bias for this domain.…”

Section: Allocation Concealmentmentioning

confidence: 99%

Section: Activities Of Daily Livingmentioning

confidence: 99%

See 3 more Smart Citations

Oral nutritional interventions in frail older people who are malnourished or at risk of malnutrition: a systematic review

Thomson

Rice

Arisa

et al. 2022

Health Technol Assess

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Nutritional supplementation for hip fracture aftercare in older people

Avenell

Smith

Curtain

et al. 2016

Cochrane Database of Systematic Reviews

169

149

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Nutrition support in hospitalised adults at nutritional risk

Feinberg

Nielsen

Korang

et al. 2017

Cochrane Database of Systematic Reviews

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There is low-quality evidence for the effects of nutrition support on mortality and serious adverse events. Based on the results of our review, it does not appear to lead to a risk ratio reduction of approximately 10% or more in either all-cause mortality or serious adverse events at short-term and long-term follow-up.There is very low-quality evidence for an increase in weight with nutrition support at the end of treatment in hospitalised adults determined to be at nutritional risk. The effects of nutrition support on all remaining outcomes are unclear.Despite the clinically heterogenous population and the high risk of bias of all included trials, our analyses showed limited signs of statistical heterogeneity. Further trials may be warranted, assessing enteral nutrition (tube-feeding) for different patient groups. Future trials ought to be conducted with low risks of systematic errors and low risks of random errors, and they also ought to assess health-related quality of life.

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Pp097-Mon Oral Nutritional Supplement (Ons) Improved Nutritional Status in Malnourished Patients Receiving Hip Fracture Surgery

Cited by 3 publications

References 0 publications

Oral nutritional interventions in frail older people who are malnourished or at risk of malnutrition: a systematic review

Oral nutritional interventions in frail older people who are malnourished or at risk of malnutrition: a systematic review

Nutritional supplementation for hip fracture aftercare in older people

Nutrition support in hospitalised adults at nutritional risk

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