Nutrition Care after Discharge from Hospital: An Exploratory Analysis from the More-2-Eat Study

Abstract

Many patients leave hospital in poor nutritional states, yet little is known about the post-discharge nutrition care in which patients are engaged. This study describes the nutrition-care activities 30-days post-discharge reported by patients and what covariates are associated with these activities. Quasi-randomly selected patients recruited from 5 medical units across Canada (n = 513) consented to 30-days post-discharge data collection with 48.5% (n = 249) completing the telephone interview. Use of nutrition care post-discharge was reported and bivariate analysis completed with relevant covariates for the two most frequently reported activities, following recommendations post-discharge or use of oral nutritional supplements (ONS). A total of 42% (n = 110) received nutrition recommendations at hospital discharge, with 65% (n = 71/110) of these participants following those recommendations; 26.5% (n = 66) were taking ONS after hospitalization. Participants who followed recommendations were more likely to report following a special diet (p = 0.002), different from before their hospitalization (p = 0.008), compared to those who received recommendations, but reported not following them. Patients taking ONS were more likely to be at nutrition risk (p < 0.0001), malnourished (p = 0.0006), taking ONS in hospital (p = 0.01), had a lower HGS (p = 0.0013; males only), and less likely to believe they were eating enough to meet their body’s needs (p = 0.005). This analysis provides new insights on nutrition-care post-discharge.

Malnourished adults’ receipt of hospital discharge nutrition care instructions: a pilot study

“…Laur et al . examined the nutrition care of adult patients 30 days after discharge. They found that only 42% (110 of 249) of patients received nutrition recommendations at discharge, and only 65% of these patients (71 of 110) followed the recommendations.…”

“…Only 14% (six of 42) of patients received nutrition-focused discharge planning from a registered dietitian (RD) or a nurse and only 19% (eight of 42) received practical nutrition supports, such as meal delivery or shopping assistance (25) . Laur et al (26) examined the nutrition care of adult patients 30 days after discharge. They found that only 42% (110 of 249) of patients received nutrition recommendations at discharge, and only 65% of these patients (71 of 110) followed the recommendations.…”

“…The most common discharge instructions related to food intake, community food services and use of ONS. Approximately 27% (66 of 249) consumed ONS post‐discharge, although it was unknown whether patients received instructions from hospital staff to do so . These studies suggest that patients who are malnourished or nutritionally at risk may not consistently receive and follow discharge care instructions that could improve outcomes.…”

Ernährungsberatung im Spannungsfeld zwischen Klinik und ambulanter Versorgung

“…Dies zeigt, dass sämtliche Interventionen, die auf eine Verbesserung der Ernährungssituation abzielen, zeitlich nicht nur während des Klinikaufenthalts stattfinden sollten, sondern auch vor (Stichwort Prähabilitation) und nach einem Klinikaufenthalt [12].…”

“…Während im Krankenhaus noch ca. 50 % der Patienten Ernährungsinformationen oder eine Beratung erhielten [12 -14], haben nur noch 7 % der Patienten im Anschluss an die Entlassung aus dem Krankenhaus Kontakt mit einer Ernährungsfachkraft, obwohl der Ernährungszustand sich teilweise seit der Entlassung weiter verschlechtert hatte [12].…”