The aim of the study is to implement a nutritional treatment when discharging older patients at risk of malnutrition. Data collected in the study will include an assessment of whether a combination of nutritional treatment and a liaison team reduces the risk of readmissions and mortality, improves nutritional status, physical function and quality of life
During hospitalization, many older patients are at risk of malnutrition. Malnutrition in older adults is related to reduced physical function, more complications, re-admissions, days in hospital and reduced quality of life. As hospitalizations are often short (approximately 5 days), it is important to focus on nutritional intake during the convalescence period. Upon discharge, a "Nutrition Gap" often occurs in practice, where the patient does not consume sufficient nutrition to ensure an optimal convalescence period. The lack of nutritional follow-up in connection with the discharge of older patients has been shown to have a markedly negative effect on, among other things, functional ability and readmissions. A study from Herlev Hospital, where the effect of a nutritional treatment upon discharge of older patients was investigated, showed a significant effect on muscle strength, quality of life and nutritional status. Another study from Herlev Hospital has shown that by associating a clinical dietitian with a liaison team and thus focusing on nutrition, the readmission rate was halved. The problem is that it has not been investigated whether such a cross-sectoral effort can be implemented in practice and the results confirmed. Hypothesis 1 is that it is possible to include and retain the older patients who are discharged with the liaison team for an effort that includes treatment of the risk of malnutrition and that the older participants find the effort relevant Hypothesis 2 is that nutritional treatment will be able to reduce the number of unintended readmissions and thereby be cost-effective. Furthermore, it is expected that the nutritional treatment will increase the participants' nutritional status, muscle strength, muscle mass, quality of life and possibly have a positive effect on mortality.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
2,000
At the day of discharge the intervention group (IG) receives a package containing foods and drinks covering dietary requirements for the next 24 h. Further, a goodie-bag containing samples of protein-rich milk-based drinks is provided. At day 4 after discharge, the IG receives dietetic counselling including a recommendation of daily exercise, and an individual nutrition plan. Information regarding recommendations of nutritional therapy after discharge is systematically and electronically communicated to the municipality. The dietician performes telephone follow-ups on day 30 and a home visit at 12 weeks
Herlev and Gentofte Hospital
Herlev, Denmark
RECRUITINGEligibility
Eligibility will be assessed as the number of patients who fulfil the inclusion criteria out of the number of patients discharged with the liaison team
Time frame: Assessed at baseline
Recruitment
Recruitment rate will be assessed as the number of patients recruited out of the number of eligible patients
Time frame: Assessed at baseline
Retention
Retention rate will be assessed as the number of patients who complete the nutritional treatment out of the total number of patients recruited
Time frame: Assessed at three months
Mortality
health care records
Time frame: 30 days, 12 weeks, 6 monts, 1 year and 3 year
Hospital re-admissions
health care records
Time frame: 30 days, 12 weeks, 6 monts, 1 year and 3 year
Health related Quality of life
Euro-qol tool EQ5D5L
Time frame: 12 weeks
Appetite
SNAQ with a score from 5 to 20 where a score at or below 14 can predict weight loss
Time frame: 30 days, 12 weeks
Muscle strenght
30 seconds chair stand
Time frame: 4 days, 30 days, 12 weeks
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Dietary intake
24 hours recall
Time frame: 30 days, 12 weeks
weight
body weight measurement
Time frame: 4 days, 30 days
muscle mass
calf circumference
Time frame: 12 weeks