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Abstract
Aim: Nutritional decline during and after acute hospitalisation is common amongst older people. This quality improvement initiative aimed to introduce a dietitian-led discharge planning and follow-up program (Hospital to Home Outreach for Malnourished Elders, HHOME) at two hospitals within usual resources to improve nutritional and functional recovery.
Methods: Prospective pre-post evaluation design was used. Medical patients aged 65+ years at-risk of malnutrition and discharged to independent living were eligible. Participants receiving nutrition discharge planning and dietetic telephone follow up for four weeks post-discharge ('HHOME') were compared to usual care ('pre-HHOME'). Nutritional (weight and mini nutritional assessment (MNA)), functional (gait speed, handgrip strength and modified Barthel index) and assessment of quality of life-6D (AQoL-6D) outcomes were measured on discharge and six weeks later.
Results: At six weeks, no significant difference in nutritional status was observed between pre-HHOME (n=39) and HHOME cohorts, although the HHOME cohort on average maintained weight while pre-HHOME cohort lost weight (0.4±2.9 kg vs -1.0±3.7 kg, P=0.060). Greater improvement in gait speed was seen in HHOME group (+0.24±0.27 vs +0.11±0.22, P=0.046) with no other significant outcome improvements. Across both cohorts, half were readmitted to hospital and 10% died within 12weeks post-discharge.
Conclusions: The nutritional discharge planning and dietetic follow up provided to older community-living malnourished patients made a small impact on nutritional and functional parameters but clinical outcomes remained poor.
Original language | English |
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Pages (from-to) | 283-290 |
Number of pages | 8 |
Journal | Nutrition and Dietetics |
Volume | 75 |
Issue number | 3 |
Publication status | Published - Jul 2018 |
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Ageing Nutrition: Research Across the Care Continuum
Marshall, S., Isenring, E., Hugo, C., Agarwal, E., Teleni, L., Reidlinger, D., Campbell, K., Van der Meij, B. & Tang, X.
1/01/14 → …
Project: Research