Self‐Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST)

Sandhu, Amindeep; Mosli, Mahmoud; Yan, Brian; Wu, Thomas; Gregor, Jamie; Chande, Nilesh; Ponich, Terry; Beaton, Melanie; Rahman, Ashrafur

doi:10.1177/0148607114566656

Cited by 57 publications

(61 citation statements)

References 13 publications

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“…Such process identifies patients with or at risk of undernutrition who will subsequently be referred for comprehensive dietetic assessment [5][6][7]. There are few reports of nutrition screening in the IBD outpatient setting [8].…”

Section: Introductionmentioning

confidence: 99%

A multicentre Study of Nutrition Risk Assessment in Adult Patients with Inflammatory Bowel Disease Attending Outpatient Clinics

et al. 2018

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Background: Overnutrition and undernutrition can affect patients with inflammatory bowel disease (IBD). Although all IBD outpatients should be screened for nutrition risk, screening is not routinely performed, potentially leading to reduced identification and treatment. This study aimed to estimate the prevalence of nutrition risk in adult IBD outpatients and the proportion of cases who discussed diet and/or nutrition during their routine clinical appointment. Methods: Adults with IBD attending outpatient clinics at 4 hospitals in Greece and in UK were recruited. Demographic and anthropometric data were collected using face-to-face patient interviews and clinical records. Patients were classified as high (i.e., body mass index [BMI] < 18.5 or 18.5–20 kg/m² and weight loss > 5%), moderate (i.e., BMI 20–25 kg/m² and weight loss > 5%) or low risk of undernutrition and high risk of obesity (i.e., BMI 25–30% and weight gain > 5%). The proportion of patients who discussed diet and/or nutrition during their clinical appointment was calculated. Results: In total, 390 IBD patients participated. Sixteen (4%) patients were underweight, 113 (29%) were overweight and 71 (18%) were obese. Twenty-one (5%) patients were at high risk of undernutrition; of these 4 (19%) were under dietetic care. Of those at high risk of undernutrition, 11 (52%) had discussed diet and/or nutrition during their routine clinical appointment. Fifty-six (14%) patients had gained more than 5% weight since their last recorded/reported weight and 19 (5%) were at high risk of obesity. Conclusions: Few patients were identified to be at high risk of undernutrition and less than a fifth of these were under dietetic care. Overnutrition is a growing problem in IBD with almost half of adult patients being overweight or obese. Diet and/or nutrition were not routinely discussed in this group of IBD outpatients.

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Section: Introductionmentioning

confidence: 99%

A multicentre Study of Nutrition Risk Assessment in Adult Patients with Inflammatory Bowel Disease Attending Outpatient Clinics

et al. 2018

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“…Malnutrition screening offers a simple and rapid process conducted by nurses or healthcare teams or patients (as self-screening) (15). We used the Malnutrition Universal Screening Tool (MUST) questionnaire to screen the risk of malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Malnutrition risk questionnaire combined with body composition measurement in malnutrition screening in inflammatory bowel disease

Csontos¹,

Molnár²,

Piri³

et al. 2016

Rev Esp Enferm Dig

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The purpose of malnutrition screening is to predict the probability of a worse outcome due to nutritional factors. The Malnutrition Universal Screening Tool (MUST) can be used for screening in inflammatory bowel disease (IBD); however, it does not provide details about body composition. Our aim was to assess the body composition and combine this with the MUST method to screen risk of malnutrition and sarcopenia. A total of 173 IBD outpatients were enrolled in this cross-sectional study. The MUST scale indicated 21.4% of IBD patients to be at risk of malnutrition. A risk of sarcopenia was detected in 27.7%. However, one third of these patients were not considered to be at risk by their MUST score. Furthermore, Crohn's disease (CD) patients had a strongly unfavorable fat-free mass index (FFMI) value compared to ulcerative colitis (UC) patients, and these differences were significant among men (FFMI: 18.62 ± 2.16 vs 19.85 ± 2.22, p = 0.02, in CD and UC males, respectively). As sarcopenia is a relevant prognostic factor, the MUST method should be expanded to include body composition analysis to detect more IBD patients at risk of malnutrition and sarcopenia in order to start their nutritional therapy immediately.

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“…Several potential explanations exist for why inpatient self-screening failed where outpatient self-screening succeeded; first, outpatients are more likely to be ambulatory, which simplifies self-weighing. Second, in outpatient trials by Mitchell (2014) and Cawood (2012), the average age of participants (43 and 55 years, respectively) was significantly younger than the average CTU inpatient (66 years; range 19-98 years) (13,15). Given that age itself is a risk factor for the cognitive and physical barriers to self-screening, inpatient screening must be tailored to a more functionally limited population.…”

Section: Discussionmentioning

confidence: 99%

“…Given the time constraints on healthcare providers (HCP), empowering patients to screen themselves for malnutrition is an appealing proposition. Previous work has demonstrated the efficacy of patients self-administering the MUST to screen for malnutrition in a variety of outpatient environments (13,15). The goal of this study was to determine the validity of self-screening with the MUST as a means of identifying inpatients at risk for malnutrition on the acute medicine unit.…”

Section: Introductionmentioning

confidence: 99%

Use of self-administered Malnutrition Universal Screening Tool (MUST) is not a valid means of identifying inpatients at risk for malnutrition on the Clinical Teaching Unit

Rahman¹,

Spicer²

2016

Canadian Journal of Nutrition

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Self‐Screening for Malnutrition Risk in Outpatient Inflammatory Bowel Disease Patients Using the Malnutrition Universal Screening Tool (MUST)

Cited by 57 publications

References 13 publications

A multicentre Study of Nutrition Risk Assessment in Adult Patients with Inflammatory Bowel Disease Attending Outpatient Clinics

A multicentre Study of Nutrition Risk Assessment in Adult Patients with Inflammatory Bowel Disease Attending Outpatient Clinics

Malnutrition risk questionnaire combined with body composition measurement in malnutrition screening in inflammatory bowel disease

Use of self-administered Malnutrition Universal Screening Tool (MUST) is not a valid means of identifying inpatients at risk for malnutrition on the Clinical Teaching Unit

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