Supportive interventions for enhancing dietary intake in malnourished or nutritionally at‐risk adults: a systematic review of nonrandomised studies

Kimber, K.; Gibbs, M.; Weekes, C. Elizabeth; Baldwin, Christine

doi:10.1111/jhn.12329

Cited by 23 publications

(21 citation statements)

References 59 publications

(189 reference statements)

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“…dementia, frailty and hip fracture) (Allen et al, 2013;Artaza-Artabe et al, 2016;Avenell et al, 2016;Droogsma et al, 2014) or intermediate outcomes (e.g. protein or energy intake) (Kimber et al, 2015;Trabal and Farran-Codina, 2015).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

Correa-Pérez

Abraha

Cherubini

et al. 2019

Ageing Research Reviews

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Section: Introductionmentioning

confidence: 99%

Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

Correa-Pérez

Abraha

Cherubini

et al. 2019

Ageing Research Reviews

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“…Quality indicators are commonly used to improve nutritional care practice in elderly care ( 1 - 3 ), and a range of different strategies has been described ( 4 - 6 ). These strategies comprise a complex range from organisational to individual aspects, requiring a package of multilevel and multicomponent approaches ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Quality indicators of nutritional care practice in elderly care

Josefsson

Nydahl

Persson

et al. 2017

The Journal of nutrition, health and aging

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ObjectivesThe aim is to explore the effects of antecedent, structural and process quality indicators of nutritional care practice on meal satisfaction and screened nutritional status among older adults in residential care homes.DesignData for this Swedish cross-sectional study regarding older adults living in residential care homes were collected by i) a national questionnaire, ii) records from the quality registry Senior Alert, iii) data from an Open Comparison survey of elderly care in 2013/2014. The data represented 1154 individuals in 117 of 290 Swedish municipalities.MeasurementsMeal satisfaction (%) and adequate nutritional status, screened by the Mini Nutritional Assessment Short Form (MNA-SF), were the two outcome variables assessed through their association with population density of municipalities and residents’ age, together with 12 quality indicators pertaining to structure and process domains in the Donabedian model of care.ResultsMeal satisfaction was associated with rural and urban municipalities, with the structure quality indicators: local food policies, private meal providers, on-site cooking, availability of clinical/community dietitians, food service dietitians, and with the process quality indicators: meal choice, satisfaction surveys, and ‘meal councils’. Adequate nutritional status was positively associated with availability of clinical/community dietitians, and energy and nutrient calculated menus, and negatively associated with chilled food production systems.ConclusionMunicipality characteristics and structure quality indicators had the strongest associations with meal satisfaction, and quality indicators with local characteristics emerge as important for meal satisfaction. Nutritional competence appears vital for residents to be well-nourished.

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“…FoU was one of the first dietetic services to promote food based interventions (FB) [55], defined as "no treatment" in the results. No systematic review [63][64][65][66] has made specific conclusions regarding nutritional interventions for undernutrition in care homes [51], due to inconsistent and limited strong quality evidence for the impact of FB on outcomes [67]. However, analysis of the three "at risk" treatments clearly indicates FoU alone ("no treatment") has a positive impact on all outcomes, although no significant difference was identified between treatments for any objective (Figs.…”

Section: Discussionmentioning

confidence: 99%

Focus on Undernutrition in Care Homes: A Retrospective Service Evaluation

Masters¹

2018

JFSE

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Let them eat cake": a retrospective service evaluation of Focus on Undernutrition in care homes. Introduction: Undernutrition is a major cause and consequence of poor health in older people, affecting 35% of residents in care homes. Focus on Undernutrition (FoU), a dietetic service delivered by dietetic assistants uses a multifaceted approach to undernutrition management. This study aims to evaluate FoU's impact on undernutrition outcome measures in care homes; including FoU's influence on weight change in residents "at risk" of undernutrition, and prevalence of undernutrition and pressure ulcers (PU). Methods: A retrospective pragmatic service evaluation was undertaken using pseudonymised data collected over 13 years on weight, undernutrition risk and PU from long-stay residents' notes before and six months after training (FoU). Results: Analysis completed on 104 homes, 4,315 residents (71.3% female; mean stay 10.8 (1-278) months) in County Durham. Following FoU a significant difference was identified for: improved rate of weight change for "at risk" residents (p < 0.001). Undernutrition risk significantly influenced weight change (low: B 1.04 kg, E 0.01 kg; moderate: B-1.79 kg, E-0.38 kg; high: B-0.83kg, E 1.00 kg, B p < 0.001, E p = 0.001). Reduced undernutrition prevalence (p < 0.001) from 32.7% to 29.1% residents "at risk" of undernutrition (moderate: B 13.1%, E 8.9%; high: B 19.6%, E 15.9%). Nutrition screening significantly improved (B 76.3%, E 98.7%, p < 0.001), reduced prevalence PU (51%, p < 0.001). PU prevalence significantly increased with undernutrition severity at baseline (p < 0.001), but not following FoU (p = 0.233) (low: B 5%, E 2.3%; moderate: B 6.9%, E 1.6%; high: B 10.5%, E 3.9%). Odds of developing PU reduced 53% (OR: 0.47). B :baseline; E :evaluation; OR: odds ratio. Conclusion: These results demonstrate dietetic assistants delivering FoU significantly improves weight, undernutrition and PU prevalence in care homes. Indicating FoU is an effective model for improving undernutrition outcomes, with the potential of reducing possible harm, such as PU in care homes.

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Supportive interventions for enhancing dietary intake in malnourished or nutritionally at‐risk adults: a systematic review of nonrandomised studies

Abstract: This systematic review describes a range of interventions that may be implemented in clinical practice. A limited range of outcomes are reported and it is difficult to draw any meaningful conclusions on the effect of the different methods.

Cited by 23 publications

References 59 publications

Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

Quality indicators of nutritional care practice in elderly care

Focus on Undernutrition in Care Homes: A Retrospective Service Evaluation

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