Evaluation of Effectiveness of Nutritional Practical Counseling for Elderly Patients at Risk of Malnutrition on Nutritional Status at Home

Study Overview
=================
Brief Summary
-----------------
At hospital, short term actions are used (adaptation of meals, oral supplementation…) to fight malnutrition. Oral supplementation can have a positive impact on weight gain. But actions should continue at home, particularly to maintain autonomy for elderly. The hypothesis is that practical workshop about enrichment and interest of foods can help malnourished patients to change their eating habits. The main goal of this study is to evaluate the effects of this workshop on improving nutritional status, measured by Mini Nutritional Assessment

Detailed Description
-----------------
This is a mono center cohort study of a 4-months follow-up on elderly patients after hospitalization. Nutritional parameters and evaluation of the quality of life will be collected during hospitalization and output during a visit at 4 months at home. These parameters will be studied in two groups : nutritional workshop vs usual dietary counseling

Official Title
-----------------
Evaluation of the Effectiveness of Nutritional Practical Counseling for Elderly Patients at Risk of Malnutrition (and Their Caregivers) on Nutritional Status at Home

Conditions
-----------------
Malnutrition

Intervention / Treatment
-----------------
* Other: dietary counseling
* Other: nutritional workshop with enrichment during a meal


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: malnourished patients or at risk of malnutrition coming back home after hospitalization affiliated to a social security system having given free, informed written consent Exclusion Criteria: Mini Mental Score <18 Incapacitated adults and psychiatric inpatients Diet indication requiring strict salt restriction Severe swallowing difficulties Patients with artificial nutrition (enteral or parenteral) Impossibility to measure weight at home Severe digestive or intestinal malabsorption Iterative nausea and vomiting Patients with rapidly progressive diseases (life expectancy less than 6 months)

Ages Eligible for Study
-----------------
Minimum Age: 75 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: control group<br>The control group will receive usual dietary counseling for enrichment. | Other: dietary counseling<br>* Patients received individualized nutritional counseling encouraging them for enrichment<br>|
| Other: workshop group<br>The workshop group will have informations about interest of foods. They will enrich a meal with foods which can easily be added without cooking. | Other: dietary counseling<br>* Patients received individualized nutritional counseling encouraging them for enrichment<br>Other: nutritional workshop with enrichment during a meal<br>* Patients received in group nutritional informations for enrichment and are encouraged to try enrichment together during a meal.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Improvement of nutritional status | global Mini Nutritional Assessment | 4 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect of the workshop on nutritional items of Mini Nutritional Assessment | specific nutritional items of Mini Nutritional Assessment | 4 months | 
| Maintaining or improving weight | Weight is determined with a Seca floor scale | 4 months | 
| Improving ingesta qualitatively and quantitatively | Ingesta are determined with a 24h-recall questionnaire | 4 months | 
| Representations and motivations on eating habits | Representations and motivations on eating habits are determined with a questionnaire with Likert responses | 4 months | 
| Rate returns to the hospital and not programmed planned |  | 4 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
malnutrition, aging, diet therapy