Clinical Interventions to Improve Nutritional Care in Older Adults and Patients in Primary Healthcare – A Scoping Review of Current Practices of Health Care Practitioners

Abstract

In light of the increasing life expectancy of Europe's population and the rising significance of active and healthy ageing relating thereto, an integrated approach of nutritional care within primary health care is gaining importance. The aim of the review was to summarize evidence on the effectiveness of nutritional interventions in primary health care. The scoping review is based upon a comprehensive literature search of relevant literature published between January 2010 and August 2021 in PubMed, CINAHL, Cochrane Database of Systematic Reviews, Embase and Medline databases. Overall, 15 studies were included for evidence synthesis and interventions were basically clustered according to their type, into 1) eHealth and tele-medical interventions; 2) targeted single interventions; and 3) comprehensive, multi-faceted interventions. The review presents diverging evidence regarding the efficacy and effectiveness of interventions for nutritional care in primary health care, however, demonstrates encouraging outcomes. eHealth and tele-medical interventions partly show a careful positive tendency. Likewise, manifold single interventions on patient level present significant improvements in patient health outcomes. Multifaceted and comprehensive interventions found in the literature also partly demonstrate significant changes in intervention groups. Primary health care represents a critical setting for the care of older citizens and patients with complex health needs. This scoping review provides an overview of current nutrition care practices in primary health care and results reinforce the need to strengthen implementation of multi-faceted interventions carried out by the inter-disciplinary primary care team for advanced nutritional care.

An exploration of the self-perceived nutrition competencies of pharmacists

“… 7 Interprofessional collaboration to deliver nutrition care has progressed in certain areas such as cancer 42 and palliative care, 43 however there is still room for improvement to drive dietary change and public education and identification of patients at risk of malnutrition. 2 , 44 , 45 Incomplete patient records and lack of shared communication between primary care providers has been highlighted as limiting the provision of clinical services by pharmacies. 46 Some feasibility studies have been carried out 46 including in the area of nutrition, but their application in community pharmacy practice in Ireland is as of yet non-existent.…”

The ability of the geriatric nutritional risk index to predict the risk of heart diseases in Korean adults: a Korean Genome and Epidemiology Study cohort

“…According to the American Heart Association and Heart Failure Society guidelines, evaluation of nutritional status is recommended for patients with heart failure ( 61 ). In addition, studies have reported that nutritional intervention may improve clinical outcomes in older adults aged ≥60 years ( 62 , 63 ). A randomized clinical trial and a cross-sectional study of community-dwelling older adults found that supplementing or enhancing their energy status and protein consumption improved their nutritional status ( 63 , 64 ) and reduced disease prevalence ( 65 ).…”

Improving the assessment of older adult’s nutrition in primary care: recommendations for a proactive, patient-centred and aetiology approach

“…Dietitians can support improved outcomes, using a variety of interventions such as training or support to individual patients and groups. 34 Evidence to support practice pattern We do not anticipate any harms or risks arising from a proactive, patient-centred and aetiology-based approach.…”

“…Similarly, encouraging interdisciplinary use of the checklist is not intended to replace dietetic input. Dietitians can support improved outcomes, using a variety of interventions such as training or support to individual patients and groups 34…”