Study circles improve the precision in nutritional care in special accommodations

Albert Westergren,Carolina Axelsson,Petra Lilja-Andersson,Christina Lindholm,Karin Petersson,Kerstin Ulander

doi:10.3402/fnr.v53i0.1950

Abstract

Background: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition (UN), appropriate nutritional care can be provided.Objective: To investigate if study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high body mass index (BMI).Design: Pre and post-intervention study.Setting: Special accommodations (nursing homes) within six municipalities were involved.Participants: In 2005, 1,726 (90.4%) of 1,910 residents agreed to participate and in 2007, 1,526 (81.8%) of 1,866 residents participated.Intervention: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities.Measurements: Risk of UN was defined as involving any of: involuntary weight loss; low BMI; and/or eating difficulties. Overweight was defined as high BMI.Results: In 2005 and 2007, 64% and 66% of residents, respectively, were at the risk of UN. In 2007, significantly more patients in the study circle municipality were accurately provided protein and energy enriched food (PE-food) compared to the no intervention municipalities. There was a decrease between 2005 and 2007 in the prevalence of low BMI in the study circle municipality, but the prevalence of overweight increased in the policy document municipality.Conclusions: Study circles improve the provision of PE-food for residents at the risk of UN and can possibly decrease the prevalence of low BMI. It is likely that a combination of study circles and implementation of a policy document focusing on screening and on actions to take if the resident is at UN risk can give even better results.

Highlights

Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored
During the two years that the study was conducted, there was a significant decrease in the number of residents with low body mass index (BMI) while there was a significant increase in the number of residents with unintentional weight loss in the total sample
There was a significant increase in the use of protein and energy enriched food (PE-food) and oral supplements between the two years (Table 1)

Summary

Introduction

Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. Objective: To investigate if study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high body mass index (BMI). Measurements: Risk of UN was defined as involving any of: involuntary weight loss; low BMI; and/or eating difficulties. There was a decrease between 2005 and 2007 in the prevalence of low BMI in the study circle municipality, but the prevalence of overweight increased in the policy document municipality. Conclusions: Study circles improve the provision of PE-food for residents at the risk of UN and can possibly decrease the prevalence of low BMI. It is likely that a combination of study circles and implementation of a policy document focusing on screening and on actions to take if the resident is at UN risk can give even better results

Objectives

Methods

Results

Discussion

Conclusion