The effectiveness, appropriateness and feasibility of nutritional screening tools in identifying adults at risk of malnutrition in the community. A comprehensive systematic review.

Abstract

Objectives 1. To identify screening tools being used in the community setting and identify their constituent components. 2. To evaluate the effectiveness of the identified components, assessing their sensitivity and specificity in identifying adults at risk of malnutrition. 3. To assess the appropriateness and feasibility of health care professionals using the components identified within a community setting. Inclusion criteria Types of participants Participants will include all adults under the care of community health teams. No exclusion will be made on the basis of medical condition and history. However, an initial review of the literature has indicated that the focus of the review is most likely to include post-operative patients, older people and patients with degenerative diseases and cancer. Types of intervention Informed by clinical expertise and a preliminary examination of the literature we expect interventions will include accounts and evaluations of the implementation of screening tools within the community setting. The screening tools under review will include MUST (Malnutrition Universal Screening Tool) (MUST, 2003), WAASP (Weight, Appetite, Ability to eat, Stress factors, Pressure sores/wounds) (WAASP, 2005) and SIP (Screening in Practice) (Ward et al 1998). Their constituent components such as BMI anthropometric measurements and dietary history will be assessed for their impact in accurately identifying adults in a community setting at risk of malnutrition. Other interventions might include improved compliance with tools by health care professionals and improved case management of adults with malnutrition in the community setting. Types of outcome measures The outcome measures will be the assessment of the validity, reliability, sensitivity, specificity, acceptability, appropriateness and feasibility of the components identified in the literature which will include BMI, anthropometric measurements and dietary history (Green & Watson 2005).