Individualised Nutritional Care for Disease-Related Malnutrition: Improving Outcomes by Focusing on What Matters to Patients

Abstract

Delivering care that meets patients’ preferences, needs and values, and that is safe and effective is key to good-quality healthcare. Disease-related malnutrition (DRM) has profound effects on patients and families, but often what matters to patients is not captured in the research, where the focus is often on measuring the adverse clinical and economic consequences of DRM. Differences in the terminology used to describe care that meets patients’ preferences, needs and values confounds the problem. Individualised nutritional care (INC) is nutritional care that is tailored to a patient’s specific needs, preferences, values and goals. Four key pillars underpin INC: what matters to patients, shared decision making, evidence informed multi-modal nutritional care and effective monitoring of outcomes. Although INC is incorporated in nutrition guidelines and studies of oral nutritional intervention for DRM in adults, the descriptions and the degree to which it is included varies. Studies in specific patient groups show that INC improves health outcomes. The nutrition care process (NCP) offers a practical model to help healthcare professionals individualise nutritional care. The model can be used by all healthcare disciplines across all healthcare settings. Interdisciplinary team approaches provide nutritional care that delivers on what matters to patients, without increased resources and can be adapted to include INC. This review is of relevance to all involved in the design, delivery and evaluation of nutritional care for all patients, regardless of whether they need first-line nutritional care or complex, highly specialised nutritional care.

Communication about Disease-Related Malnutrition in the Perspective of Health Professionals in General Practice and Patients

“…The purpose of this study was to investigate which elements are perceived necessary for an early management of DRM in general practice and based on this knowledge provide recommendations for an effective communication strategy for patients at nutritional risk in general practice. The data suggests that early guidance including consideration of the individual patient needs, preferences and values is recommended, as also recommended by guidelines and other studies, however in other settings [26]. Our findings reveal that patients with UWL who approach the GP may be affected by many worries and opposing emotions, which can block the information that the GPs and/or GPNs may try to communicate, unless a careful strategy for communication is used.…”

“…Only two nurses reflect on the individual literacy competences of patients which may very much affect patient's abilities to enhance health Volume 5; Issue 10 Int J Nurs Health Care Res, an open access journal ISSN: 2688-9501 literacy. Even though a model was made for the individualized care for patients with nutritional challenges, this model does not regard learning abilities, as we found necessary in the opinion of experienced nurses and patients [26].…”

“…It is central to use a communication strategy to ensure effective health communication. An individual approach to nutritional guidance is recommended, however with no focus on the general practice setting [26].…”

Nutrition intervention informed by indirect calorimetry compared to predictive equations to achieve weight goals in geriatric rehabilitation inpatients: The NEED study

“…Providing adequate energy to meet individualised nutritional requirements and improve nutritional status, consequently to maintain or improve function is a priority aim in clinical nutrition (5), particularly in geriatrics and rehabilitation (6).…”

Smart Solutions for Diet-Related Disease Management: Connected Care, Remote Health Monitoring Systems, and Integrated Insights for Advanced Evaluation

“…Care coordination: disease management often involves a multidisciplinary approach, with healthcare professionals collaborating to provide integrated and coordinated care, ensuring that patients receive comprehensive support [46,47].…”