Evidence-Based Recommendations for Addressing Malnutrition in Health Care: An Updated Strategy From the feedM.E. Global Study Group

Abstract

The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increased complications (pressure ulcers, infections, falls), longer hospital stays, more frequent readmissions, increased costs of care, and higher risk of mortality. Yet disease-related malnutrition still goes unrecognized and undertreated. To help improve nutrition care around the world, the feedM.E. (Medical Education) Global Study Group, including members from Asia, Europe, the Middle East, and North and South America, defines a Nutrition Care Pathway that is simple and can be tailored for use in varied health care settings. The Pathway recommends screen, intervene, and supervene: screen patients' nutrition status on admission or initiation of care, intervene promptly when needed, and supervene or follow-up routinely with adjustment and reinforcement of nutrition care plans. This article is a call-to-action for health caregivers worldwide to increase attention to nutrition care.

The management of the patient with malnutrition: from evidence to clinical practice

“…Furthermore, in accordance with the call to action of feed Medical Education (M.E.) Global Study Group, 51 an international expert group on nutrition, the general outlines of every single CP specific to each center, if necessary, will be the same as the CP proposed by feed M.E. Global Study Group; these will be applied to the patient hospitalized at the time, during hospitalization and at discharge (Figure 3).…”

“…Global Study Group; these will be applied to the patient hospitalized at the time, during hospitalization and at discharge (Figure 3). 51 Concerning the diagnosis moment, the CP proposed by feed M.E. Global Study Group suggests using the Subjective Global Assessment for all adults and MNA for older people; once identified the malnourished patient, the malnutrition CP recommends a customized nutritional treatment within 24-48 h of admission.…”

Nutrition as a Vital Sign: Progress Since the 1990 Multidisciplinary Nutrition Screening Initiative and Opportunities for Nursing

“…(Medical Education) Global Study Group defines a nutrition care pathway that can be varied depending on the healthcare setting. The Pathway's primary strategies are screen, intervene, and supervene: screen patients' nutrition status on admission or initiation of care, intervene promptly when needed, and supervene or follow up routinely with adjustment and reinforcement of nutrition care plans [99].…”

Health care costs matter: a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?

“…6 Many studies have shown that the prevalence of malnutrition in North American, European, Asian, Australian, and Latin American hospitals can range from 20% to ≥50%. 4,7 However, malnutrition is not limited to patients in hospitals; a UK study found that 93% of the estimated 3 million people malnourished or at risk of malnutrition live in the community. 8 Such malnourished community-dwelling individuals are 2-3 times more likely than their well-nourished counterparts to require additional clinic visits or to be admitted to the hospital.…”

“…10,11 Medical nutrition, the clinical application of knowledge about the role played by nutrients in health and disease, is increasingly being used in interventions that have been shown to improve patients' quality of life and other health outcomes while also reducing overall health care costs. 4,7,12 Such cost reductions result from lowering the readmission rates, 13,14 decreasing the length of hospital stay, 15 reducing the frequency of complications (postsurgical infections and pressure ulcers), 12,16,17 and ultimately reducing the overall episode cost. 18,19 Many of the reviews of medical nutrition and health economics focus on studies of a particular clinical condition, a specific intervention or outcome, and/or a distinct geographic location.…”