The Effect of Megestrol Acetate on Oral Food and Fluid Intake in Nursing Home Residents

Abstract

Objectives The objective of this study was to evaluate the effect of megestrol acetate (Megace ®OS; Bristol-Myers Squibb, Princeton, NJ) on the oral food and fluid intake of nursing home (NH) residents under two conditions: usual NH care and optimal mealtime feeding assistance. Design and setting We conducted a prospective, preliminary trial in four NHs. Participants Participants (n = 17) were recruited from a larger study designed to assess nutritional care quality. Eligibility for the Megace ®OS trial required participants to consistently eat less than 75% of most meals under both usual NH care and optimal feeding assistance conditions at baseline. Intervention Megace ®OS, an oral liquid suspension of megestrol acetate, was given daily in a 400-mg dose for 63 days. Measurements Each participant’s oral food and fluid intake was monitored weekly for 1 day (three meals) during which research staff conducted direct observations of usual NH care (weeks 1, 3, and 5 and day 63) or provided optimal feeding assistance (weeks 2, 4, and 6). Average total percent intake was compared from baseline across the assessment weeks of the trial under the two mealtime care conditions. Results Megace ®OS had a significant effect on oral food and fluid intake only under the optimal mealtime feeding assistance condition, in which average total percent eaten increased from 50% (±15%) at baseline to 63% (±14%) post-63 days of the trial. There was no change in participants’ oral food and fluid intake under the usual NH care condition (average total percent intake at baseline 43% ± 12% vs. 43% ± 20% post-63 days). Conclusion The results of this preliminary study suggest that Megace ®OS is not an effective nutritional intervention to increase oral intake under usual NH care conditions, which is often characterized by inadequate feeding assistance. However, Megace ®OS in combination with optimal mealtime feeding assistance does significantly increase oral intake in a frail NH sample at high risk for weight loss. The objective of this study was to evaluate the effect of megestrol acetate (Megace ®OS; Bristol-Myers Squibb, Princeton, NJ) on the oral food and fluid intake of nursing home (NH) residents under two conditions: usual NH care and optimal mealtime feeding assistance. We conducted a prospective, preliminary trial in four NHs. Participants (n = 17) were recruited from a larger study designed to assess nutritional care quality. Eligibility for the Megace ®OS trial required participants to consistently eat less than 75% of most meals under both usual NH care and optimal feeding assistance conditions at baseline. Megace ®OS, an oral liquid suspension of megestrol acetate, was given daily in a 400-mg dose for 63 days. Each participant’s oral food and fluid intake was monitored weekly for 1 day (three meals) during which research staff conducted direct observations of usual NH care (weeks 1, 3, and 5 and day 63) or provided optimal feeding assistance (weeks 2, 4, and 6). Average total percent intake was compared from baseline across the assessment weeks of the trial under the two mealtime care conditions. Megace ®OS had a significant effect on oral food and fluid intake only under the optimal mealtime feeding assistance condition, in which average total percent eaten increased from 50% (±15%) at baseline to 63% (±14%) post-63 days of the trial. There was no change in participants’ oral food and fluid intake under the usual NH care condition (average total percent intake at baseline 43% ± 12% vs. 43% ± 20% post-63 days). The results of this preliminary study suggest that Megace ®OS is not an effective nutritional intervention to increase oral intake under usual NH care conditions, which is often characterized by inadequate feeding assistance. However, Megace ®OS in combination with optimal mealtime feeding assistance does significantly increase oral intake in a frail NH sample at high risk for weight loss.