Adult malnutrition, nutritional interventions and outcomes in Singapore: a scoping review of local studies for the past 20 years

Abstract

Background: There is currently no review published on the prevalence and incidence of malnutrition in Singapore across various populations, or what interventions or policies are in place for preventing/treating malnutrition. Objectives: This review aims to determine the: (a) incidence and prevalence of malnutrition in the community, and in acute, intermediate and long-term care facilities; (b) interventions implemented for screening, assessing and treating/preventing malnutrition; (c) specific clinical populations investigated for malnutrition or nutritional therapy; and (d) implications of malnutrition and effectiveness of treating malnutrition or using nutritional therapy in Singapore. Methods: A structured search strategy was applied to available electronic databases (MEDLINE/PubMed, EMBASE, CINAHL, the Cochrane Library and Google Scholar) using selected search terms, with additional reports and grey literature identified using iterative searches. Results: Forty-two articles were found, with the majority of research performed in the community and acute care settings. Malnutrition screening and assessment is the most common nutritional research performed in Singapore. Approximately 14.7% to 65.0% of acute care and 2.8% to 31.5% of community populations are found to be malnourished. Limited interventional and economic-related studies are available. Conclusion: Malnutrition rates in Singapore appear to be similar to other developed countries. Future studies will need to focus on nutritional intervention, cost-effectiveness analyses and specific populations such as the underprivileged, chronically ill and those dependent on nutritional support.

Nutrition Care after Hospital Discharge in Singapore: Evidence-Based Best-Practice Recommendations

“…Recent studies have reported a similar prevalence of malnutrition in hospitalised patients today to what there was then: 14.0-32.3% among surgical patients [4,5], 22.6-50.0% among patients with cancer [4,[6][7][8][9], and 38.0-78.0% among ICU patients [10,11]. While national prevalence data in Singapore are limited, a recent scoping review of local studies reported a malnutrition prevalence of 14.7-65.0% in acute care settings [12]. Among hospitalised older patients (≥65 years) in Singapore, about 35.0% were malnourished at admission [13].…”

A Cost–Consequence Analysis of Nutritional Interventions Used in Hospital Settings for Older Adults with or at Risk of Malnutrition

“…DALYs were used for this CCA instead of the more commonly known quality-adjusted life years (QALYs), which focus more on quality of life and treatment outcomes [13]. Hence, QALYs may not adequately capture the long-term and multifaceted nature of malnutrition's impact, particularly in vulnerable populations, where the disease burden manifests through a combination of premature mortality and long-term disability [22].…”

“…The CCA indicated that 28.15 disability-adjusted life years (DALYs) were averted across the Singapore Health Services' (SingHealth, Singapore) institutions of Singapore General Hospital, Changi General Hospital, and Seng Kang General Hospital due to the successful treatment or prevention of malnutrition by dietitians from 1 April 2021 to 31 March 2022. This was based on an estimated 45,000 patients (from existing data, 27% of patients were on oral nutrition with malnutrition) [21,22], with 68% (range: 53% to 83%) of the malnourished patients returning to a well-nourished state after treatment [19,20].…”