Modifications des recommandations de la Haute Autorité de santé concernant le diagnostic de la dénutrition : application par les professionnels de la nutrition en pratique clinique

Abstract

IntroductionThe new diagnostic criteria of the french health authority (HAS) for undernutrition suggest assessing patients’ muscle strength and/or mass. The methods are less available in practice. Albumin levels are now considered as a criterion for the severity of undernutrition. Our aim was to assess the impact of these changes in recommendations on the practices of professionals involved in screening for and diagnosing undernutrition. Materials and methodsThe Scientific Advisory Board of the french speaking society for clinical nutrition and metabolism (SFNCM) used google forms® to conduct an e-mail survey of the society's members. ResultsWe obtained 363 responses. Eighty-seven percent and 77% of respondents respectively stated that they rarely or never assess muscle mass or strength. A minority of professionals said they were equipped to carry out these assessments (38% had a dynamometer, 23% an impedancemeter). However, even those had access to them did not use them regularly. With regard to albuminemia, almost half of those questioned said they used it to diagnose malnutrition. ConclusionFew of the professionals responsible for diagnosing undernutrition are able to assess muscle mass and strength, due to a lack of muscle mass and strength due to a lack of access to techniques. The use of albumin levels as a marker of the severity of undernutrition seems ambiguous to some. The training of teams and funding for equipment would therefore seem to be prerequisites for the successful implementation of these recommendations.