Telehealth improves quality of life and protein intake in malnourished older adults: A meta-analysis

Wolfgang Marx, Jaimon T Kelly, Megan Crichton, Dana L. Craven, Jorja Collins, Hannah Mackay, Elisabeth Isenring, Skye Marshall

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Abstract

Feasible delivery modalities for treating malnourished older adults living at home are of interest so as to improve patient outcomes and health service use. This systematic review and meta-analysis aimed to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Five databases were searched for studies in any language in November 2017. Quality was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Thirteen publications (n=9 studies) had mostly low to unclear risk of bias. Participants were patients following hospital discharge (n=7 studies), with kidney disease (n=1 study), or cancer (n=1 study). Telehealth via telephone consultations (n=7 studies, 0-31% attrition) appear more feasible than internet-enabled telemedicine devices (n=2 studies, 50-61% attrition). Ten meta-analyses found that compared to usual care or no intervention, telehealth interventions improved protein intake by 0.13g/kg body weight per day ([95%CI: 0.01-0.25]; P=0.03; n=2 studies; n=200 participants; I2=41%; GRADE level: low) and improved quality of life (standardised mean difference: 0.55 [95%CI: 0.11-0.99]; P=0.01; n=4 studies with n=9 quality of life tools; n=248 participants; I2=84%: GRADE level: very low). There were non-significant trends towards improved nutrition status, physical function, energy intake, hospital readmission rates, and mortality in the intervention groups. This systematic review identified telephone consultations are an effective and feasible delivery method of malnutrition-related interventions for older adults living at home and are likely to result in clinical improvements compared to usual care or no intervention. Further research with larger samples and stronger study designs are now required.
Original languageEnglish
Article number18
Pages (from-to)56-57
Number of pages2
JournalNutrition and Dietetics
Volume76
Issue numberS1
DOIs
Publication statusPublished - 13 Aug 2019
EventDietitians Association of Australia 36th National Conference: More than meets the eye - The Gold Coast Convention and Exhibition Centre, Gold Coast, Australia
Duration: 12 Aug 201914 Aug 2019
Conference number: 36th
https://daa2019.com.au
https://daa2019.com.au/

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Telemedicine
Meta-Analysis
Quality of Life
Telephone
Malnutrition
Proteins
Referral and Consultation
Independent Living
Patient Readmission
Kidney Diseases
Hospital Mortality
Energy Intake
Nutritional Status
Internet
Health Services
Publications
Language
Body Weight
Databases
Equipment and Supplies

Cite this

Marx, Wolfgang ; Kelly, Jaimon T ; Crichton, Megan ; Craven, Dana L. ; Collins, Jorja ; Mackay, Hannah ; Isenring, Elisabeth ; Marshall, Skye. / Telehealth improves quality of life and protein intake in malnourished older adults: A meta-analysis. In: Nutrition and Dietetics. 2019 ; Vol. 76, No. S1. pp. 56-57.
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abstract = "Feasible delivery modalities for treating malnourished older adults living at home are of interest so as to improve patient outcomes and health service use. This systematic review and meta-analysis aimed to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Five databases were searched for studies in any language in November 2017. Quality was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Thirteen publications (n=9 studies) had mostly low to unclear risk of bias. Participants were patients following hospital discharge (n=7 studies), with kidney disease (n=1 study), or cancer (n=1 study). Telehealth via telephone consultations (n=7 studies, 0-31{\%} attrition) appear more feasible than internet-enabled telemedicine devices (n=2 studies, 50-61{\%} attrition). Ten meta-analyses found that compared to usual care or no intervention, telehealth interventions improved protein intake by 0.13g/kg body weight per day ([95{\%}CI: 0.01-0.25]; P=0.03; n=2 studies; n=200 participants; I2=41{\%}; GRADE level: low) and improved quality of life (standardised mean difference: 0.55 [95{\%}CI: 0.11-0.99]; P=0.01; n=4 studies with n=9 quality of life tools; n=248 participants; I2=84{\%}: GRADE level: very low). There were non-significant trends towards improved nutrition status, physical function, energy intake, hospital readmission rates, and mortality in the intervention groups. This systematic review identified telephone consultations are an effective and feasible delivery method of malnutrition-related interventions for older adults living at home and are likely to result in clinical improvements compared to usual care or no intervention. Further research with larger samples and stronger study designs are now required.",
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year = "2019",
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Telehealth improves quality of life and protein intake in malnourished older adults: A meta-analysis. / Marx, Wolfgang; Kelly, Jaimon T; Crichton, Megan; Craven, Dana L.; Collins, Jorja; Mackay, Hannah; Isenring, Elisabeth; Marshall, Skye.

In: Nutrition and Dietetics, Vol. 76, No. S1, 18, 13.08.2019, p. 56-57.

Research output: Contribution to journalMeeting AbstractResearchpeer-review

TY - JOUR

T1 - Telehealth improves quality of life and protein intake in malnourished older adults: A meta-analysis

AU - Marx, Wolfgang

AU - Kelly, Jaimon T

AU - Crichton, Megan

AU - Craven, Dana L.

AU - Collins, Jorja

AU - Mackay, Hannah

AU - Isenring, Elisabeth

AU - Marshall, Skye

PY - 2019/8/13

Y1 - 2019/8/13

N2 - Feasible delivery modalities for treating malnourished older adults living at home are of interest so as to improve patient outcomes and health service use. This systematic review and meta-analysis aimed to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Five databases were searched for studies in any language in November 2017. Quality was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Thirteen publications (n=9 studies) had mostly low to unclear risk of bias. Participants were patients following hospital discharge (n=7 studies), with kidney disease (n=1 study), or cancer (n=1 study). Telehealth via telephone consultations (n=7 studies, 0-31% attrition) appear more feasible than internet-enabled telemedicine devices (n=2 studies, 50-61% attrition). Ten meta-analyses found that compared to usual care or no intervention, telehealth interventions improved protein intake by 0.13g/kg body weight per day ([95%CI: 0.01-0.25]; P=0.03; n=2 studies; n=200 participants; I2=41%; GRADE level: low) and improved quality of life (standardised mean difference: 0.55 [95%CI: 0.11-0.99]; P=0.01; n=4 studies with n=9 quality of life tools; n=248 participants; I2=84%: GRADE level: very low). There were non-significant trends towards improved nutrition status, physical function, energy intake, hospital readmission rates, and mortality in the intervention groups. This systematic review identified telephone consultations are an effective and feasible delivery method of malnutrition-related interventions for older adults living at home and are likely to result in clinical improvements compared to usual care or no intervention. Further research with larger samples and stronger study designs are now required.

AB - Feasible delivery modalities for treating malnourished older adults living at home are of interest so as to improve patient outcomes and health service use. This systematic review and meta-analysis aimed to determine the efficacy of telehealth methods in delivering malnutrition-related interventions to community-dwelling older adults. Five databases were searched for studies in any language in November 2017. Quality was assessed using the Cochrane Risk of Bias tool and the GRADE approach. Thirteen publications (n=9 studies) had mostly low to unclear risk of bias. Participants were patients following hospital discharge (n=7 studies), with kidney disease (n=1 study), or cancer (n=1 study). Telehealth via telephone consultations (n=7 studies, 0-31% attrition) appear more feasible than internet-enabled telemedicine devices (n=2 studies, 50-61% attrition). Ten meta-analyses found that compared to usual care or no intervention, telehealth interventions improved protein intake by 0.13g/kg body weight per day ([95%CI: 0.01-0.25]; P=0.03; n=2 studies; n=200 participants; I2=41%; GRADE level: low) and improved quality of life (standardised mean difference: 0.55 [95%CI: 0.11-0.99]; P=0.01; n=4 studies with n=9 quality of life tools; n=248 participants; I2=84%: GRADE level: very low). There were non-significant trends towards improved nutrition status, physical function, energy intake, hospital readmission rates, and mortality in the intervention groups. This systematic review identified telephone consultations are an effective and feasible delivery method of malnutrition-related interventions for older adults living at home and are likely to result in clinical improvements compared to usual care or no intervention. Further research with larger samples and stronger study designs are now required.

U2 - 10.1111/1747-0080.12567

DO - 10.1111/1747-0080.12567

M3 - Meeting Abstract

VL - 76

SP - 56

EP - 57

JO - Nutrition and Dietetics

JF - Nutrition and Dietetics

SN - 1032-1322

IS - S1

M1 - 18

ER -