Clinical trial NCT06706661: Implementation of Nutritional Efforts on Discharged Older Patients
Official title: Implementation of Nutritional Treatment to Older Patients Discharged With the Liaison Team
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Malnutrition
Keywords: food
dietician
malnutrition
nutrition risk
quality of life
muscle strength
readmissions
mortality
multimodal
Lead sponsor: Herlev and Gentofte Hospital
Sponsor class: OTHER
First posted: 2024-11-26
Enrollment: 2000
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: 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

Detailed description: 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.

Eligibility criteria: Inclusion Criteria:

Prescription of the Liaison team At nutritional risk according to NRS2002 Age 50+ Can read, hear and understand Danish or English Cognitive able to participate in the study, based on whether they are informed in time, place and own data

Exclusion Criteria:

Receives enteral or parenteral nutrition Following a special diet including texture modified food and drinks Short life expectancy Not deemed eligible by the project staff

Primary outcomes:
measure: Eligibility
timeFrame: Assessed at baseline
measure: Recruitment
timeFrame: Assessed at baseline
measure: Retention
timeFrame: Assessed at three months
Secondary outcomes:
measure: Mortality
timeFrame: 30 days, 12 weeks, 6 monts, 1 year and 3 year
measure: Hospital re-admissions
timeFrame: 30 days, 12 weeks, 6 monts, 1 year and 3 year
measure: Health related Quality of life
timeFrame: 12 weeks
measure: Appetite
timeFrame: 30 days, 12 weeks
measure: Muscle strenght
timeFrame: 4 days, 30 days, 12 weeks
measure: Dietary intake
timeFrame: 30 days, 12 weeks
measure: weight
timeFrame: 4 days, 30 days
measure: muscle mass
timeFrame: 12 weeks
Other outcomes:
Locations:
city: Herlev
country: Denmark
facility: Herlev and Gentofte Hospital
Study officials:
References:
citation: Beck A, Andersen UT, Leedo E, Jensen LL, Martins K, Quvang M, Rask KO, Vedelspang A, Ronholt F. Does adding a dietician to the liaison team after discharge of geriatric patients improve nutritional outcome: a randomised controlled trial. Clin Rehabil. 2015 Nov;29(11):1117-28. doi: 10.1177/0269215514564700. Epub 2014 Dec 31.
citation: Munk T, Svendsen JA, Knudsen AW, Ostergaard TB, Thomsen T, Olesen SS, Rasmussen HH, Beck AM. A multimodal nutritional intervention after discharge improves quality of life and physical function in older patients - a randomized controlled trial. Clin Nutr. 2021 Nov;40(11):5500-5510. doi: 10.1016/j.clnu.2021.09.029. Epub 2021 Sep 24.