311 Nutrition and dietetics on a Frailty at the Front Door Team, what does it look like?

Abstract

Abstract Background A dietitian was introduced to the Frailty at the Front Door team (FFDT) in January 2022. The introduction of the Malnutrition Screening Tool (MST) to the Comprehensive Geriatric Assessment (CGA) resulted in a 47% increase in dietetic referrals. The aim of this study was to understand the characteristics of this population and how intervention was initiated. Methods Over a five month period, data was collected from the CGAs administered. Gender, Clinical Frailty Score (CFS), MST score (high risk of malnutrition is defined as MST ≥2), method of referral, patients admitted under a specialty, referrals to Community Nutrition and Dietetics Services (CNDS) and those discharged from dietetics. The data was prospectively entered into an excel spreadsheet and analysed using descriptive statistics. Results 206 frail older adults (≥ 75 yrs) were referred and seen for dietetic intervention. Male to female ratio was 1: 1.75.The mean CFS was 5.8. 89% (n = 183) had MST ≥2. 83% (n = 171) of referrals were made by FFDT, 6% (n = 12) were referred via the hospitals’ electronic referral system. 64% (n = 132) were admitted to the acute hospital while a further 20% (n = 41) were referred to CNDS. The remaining 16% were either transferred to a different hospital or discharged from the dietetics service. Of those admitted, the data was broken down into the top 5 specialities; Geriatrics: 18% (n = 37), Acute Medicine: 16.5% (n = 34), Endocrinology: 12% (n = 25), General Medicine: 10% (n = 20) and Respiratory: 8.2% (n = 17). Conclusion High risk of malnutrition is highly prevalent in frail older adults presenting to the ED and through a number of medical specialties. Increased awareness identifies these patients so that targeted interventions early can reduce adverse outcomes in hospital or the community. Screening for malnutrition with a dietitian embedded in the FFDT identifies a much bigger proportion of those who need intervention than the traditional referral method.