Nutritional Intervention in a Cross-sector Model for the Rehabilitation of Geriatric Patients

Study Overview
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Brief Summary
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Based on an established Follow-home-programme offered at discharge from hospital the aim of this study is to test a model of how nutritional intervention in elderly patients can be systematized and quality assured in the transition between sectors. Furthermore the aim is to demonstrate that this model has a positive effect on the functioning and well-being of the elderly patient. The purpose of the Follow-home-programme is to facilitate the transition of the elderly patient between hospital and private home in order to follow-up on any medical, nursing- or retraining-related intervention necessary to the rehabilitation of the patient. However this offer does not focus on nutrition in particular. This is a problem as many elderly patients are known to develop a poor nutritional status due to low appetite, disease etc. Our hypothesis is that adding a systematic nutritional focus to the Follow-home intervention programme will promote the rehabilitation of the elderly patient further. The nutritional intervention in our study will focus on improving energy- and protein intake and we will measure the effect on the patient's functional abilities, quality of life and rate of hospital readmissions. The intervention model will be based on individualized nutritional counselling by a registered dietician in the patients home.

Detailed Description
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The study is designed as a 12 week randomized, controlled intervention study. The study sample will consist of 80 geriatric patients admitted to a medical ward at Herlev University Hospital in Copenhagen, Denmark. The patients will be equally distributed into the control and the intervention group. The control group will follow the usual follow-home programme. The intervention group will also follow this programme, but will additionally be offered 3 home visits by a registered dietician. Interdisciplinary information exchange will take place through established communication channels eg. patient records, visitations. Before and after the intervention data on the patient eg. hand-grip strength, nutritional status, dietary intake, functional abilities, well-being and activities of daily living will be gathered.

Official Title
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Effect of Nutritional Intervention in a Cross-sector Model for the Rehabilitation of Undernourished Geriatric Medical Patients: a Randomized Controlled Trial.

Conditions
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Malnutrition

Intervention / Treatment
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* Dietary Supplement: Individual nutritional therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Geriatric medical patients Age +70 years Nutritional risk according to the level 1 screen in Nutritional Risk Screening 2002 (NRS2002) Nutritional therapy for at least 3 days and at least in two daily meals during the hospitalization period Participation in the standard Follow-home programme Exclusion Criteria: Dementia Expected readmissions Terminal disease Non-danish speaking Not able to perform Hand grip test Planning weight reducing diet

Ages Eligible for Study
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Minimum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Individual nutritional therapy<br>Individual nutritional therapy provided by registered dietician by means of three Home-visits | Dietary Supplement: Individual nutritional therapy<br>* Individual nutritional therapy provided by registered dietician by means of three Home-visits<br>|
| No Intervention: Standard Follow-home programme<br>Standard Follow-home programme without individual nutritional therapy | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hand grip strength |  | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional status | Chair stand, mobility, disability and rehabilitation capacity | 12 week | 
| Nutritional status | Weight, BMI, energy and protein intake, distribution of protein intake | 12 weeks | 
| Need of social services | Home care, home nursing, meals-on-wheels | 12 weeks | 
| Readmissions |  | 6 months before and 1½ year after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Nutrition, Rehabilitation, Weightloss