PTH-241 ‘it made a big difference’-investigation of the patient experience of a community dietetic domiciliary service for patients at risk of malnutrition

Abstract

<h3>Introduction</h3> Early identification of patients at risk of malnutrition and onward referral to dietetic service is advocated in best practice guidelines.¹Patients who are housebound are not able to attend dietitian clinic appointments require a domiciliary community dietetic service (CNDS). Data is lacking in relation to the patients’ experience of this type of service in the Irish setting. <h3>Aim</h3> To investigate patient experience and satisfaction with CNDS domiciliary service for patients at risk of malnutrition in 4 midlands counties in the Republic of Ireland (ROI). <h3>Method</h3> A random sample of patients who were actively receiving a domiciliary service from the CNDS were contacted and invited to be interviewed by an independent dietitian researcher at their home. A semi-structured interview-assisted questionnaire was used. The interview was audio-recorded and later transcribed for content analysis. <h3>Results</h3> Out of 20 patients contacted by the researcher, 12 participants (4 male, 8 female) were available to take part in the study. In 2/10 cases carers were interviewed as a proxy for patients who had advanced dementia. Average age of patients was 79 years (Range 62–94 years). All participants (n = 12) could recall the last visit they had received from the community dietitian (CD). All (n = 12) were satisfied with the service provided and many commented that a domiciliary visit made them feel supported. The majority of patients (10/12) felt they needed a domiciliary service. Most (10/12) participants could recall advice given by the CD however only half of those surveyed felt they were coping better with their diet (including supplement usage) after receiving the advice. <i>“I’ve become more aware what I should and should not do’. </i>Seven out of 12 participants felt the CNDS service had improved their overall quality of life such as improved health, energy, and appetite. <h3>Conclusion</h3> The finding that all patients receiving a domiciliary service from the CNDS are satisfied with the service and assessment carried out by the dietitan is encouraging. However the results suggest that many patients requiring a domically CNDS service still struggle to cope with dietary changes to improve nutritional intake despite receiving dietary advice and prescribed oral nutritional supplements. <h3>Disclosure of interest</h3> None Declared. <h3>Reference</h3> Nutrition support in adults: oral nutritional support, enteral tube feeding, and parenteral nutrition (2006). London, National Institute for Health and Clinical Excellence (NICE)