What role for oral nutritional supplements in primary care?

Abstract

Malnutrition, a deficiency of energy, protein and other nutrients, is a cause of health problems and adverse clinical outcomes. It has been estimated that a significant number of people have, or are at risk of, malnutrition and the National Institute for Heaxlth and Care Excellence (NICE) has recognised the need to improve healthcare professionals' knowledge of the causes, effects and treatment of malnutrition. However, NICE acknowledged that "there is no clear evidence available as to whether screening is really beneficial or how it should be carried out". One of the key elements to improve or maintain nutritional intake for people with malnutrition is the provision of nutrition support, including dietary advice, the use of fortified food and additional snacks. Although for some people oral nutritional supplements (ONS) may be needed, their use can be limited by poor compliance due to low palatability or unwanted effects such as nausea and diarrhoea. Without appropriate assessment, treatment goals and regular review processes, the provision of ONS products may be ineffective and waste NHS resources. Here, we discuss the place of nutritional supplements in the management of malnutrition.