A telephone support program for patients with home enteral nutrition contributes to nutrition status and quality of life maintenance and reduces health resource use

Abstract

Background Appropriate patient/caregiver training and continuity of care after hospital discharge are key factors for the success of home enteral nutrition (HEN). This study aims to assess the effects of a specific patient support program (PSP) on the nutrition status, health‐related quality of life (HRQoL), and healthcare resource utilization and associated costs of patients with HEN. Methods Observational study of adult patients with HEN enrolled in a PSP. Sociodemographic variables (baseline), HRQoL (NutriQoL) and nutrition status (Mini Nutritional Assessment [MNA]) (baseline, 6 months after PSP enrollment), and use of unplanned HEN‐related healthcare resources (6 months prior to or after PSP enrollment) were recorded. HEN‐related resource cost was estimated from total resources used (all patients) and each resource cost. Data were analyzed with Stata program (v. 14), considering P < 0.05 as significant. Results Forty‐three patients were included in the study (mean age, 72 years [SD = 21]; 54% women; mean HEN duration, 4 years [SD = 5]). A total of 401 calls were recorded in the PSP, 7% made proactively by the patient. HRQoL and nutrition status remained stable during the study period (NutriQoL baseline, 64; 6‐months, 66; P = 0.3737; MNA baseline, 10; 6‐months, 10; P = 0.0675). Unplanned resources amounted to €6229 (US $5563) and €4711 (US $4207) before and after PSP enrollment, respectively. Cost savings, representing €1518 (US $1356), were related to fewer emergency visits. Conclusions Health advice provided through a PSP and close patient monitoring in the hospital can help to maintain patients’ nutrition status and HRQoL and to reduce the use of certain unplanned HEN‐related resources, leading to cost savings.