Impact of nutritional and educational support on home enteral nutrition.


Journal

Journal of health, population, and nutrition
ISSN: 2072-1315
Titre abrégé: J Health Popul Nutr
Pays: Bangladesh
ID NLM: 100959228

Informations de publication

Date de publication:
22 05 2023
Historique:
received: 03 10 2022
accepted: 10 05 2023
medline: 24 5 2023
pubmed: 23 5 2023
entrez: 22 5 2023
Statut: epublish

Résumé

Home Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational program of HEN patients was evaluated. A prospective, observational, real-life, multicenter study was performed in 21 Spanish Hospital. Patients receiving HEN by nasogastric tube or ostomy were included. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational program. To calculate the energy and protein requirements, the FAO/WHO/UNU formula was used considering the adjusted weight of the patients. All data were analyzed using SPSS.24. 414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 (25.3%) were diabetic. The mean weight was 59.3 ± 10.4 kg and BMI 22.6 ± 3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p < 0.05). Tolerance problems, diarrhea and abdominal distension fell between the 3- and 6-month visits (p < 0.05). Patients who received intermittent EN had fewer tolerance-related effects (OR 0.042; 95% CI 0.006-0.279) and less diarrhoea (OR 0.042; 95% CI 0.006-0.279). At the baseline and 6-month visits, compliance with the educational measures proposed by the prescriber was ≥ 99%. The nutritional assessment to prescribe individualized HEN to each patient, together with educational measures and training in the proper use of this treatment for both patients and trainers, improves nutritional status and reduces the onset of adverse events.

Sections du résumé

BACKGROUND
Home Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational program of HEN patients was evaluated.
METHODS
A prospective, observational, real-life, multicenter study was performed in 21 Spanish Hospital. Patients receiving HEN by nasogastric tube or ostomy were included. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational program. To calculate the energy and protein requirements, the FAO/WHO/UNU formula was used considering the adjusted weight of the patients. All data were analyzed using SPSS.24.
RESULTS
414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 (25.3%) were diabetic. The mean weight was 59.3 ± 10.4 kg and BMI 22.6 ± 3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p < 0.05). Tolerance problems, diarrhea and abdominal distension fell between the 3- and 6-month visits (p < 0.05). Patients who received intermittent EN had fewer tolerance-related effects (OR 0.042; 95% CI 0.006-0.279) and less diarrhoea (OR 0.042; 95% CI 0.006-0.279). At the baseline and 6-month visits, compliance with the educational measures proposed by the prescriber was ≥ 99%.
CONCLUSION
The nutritional assessment to prescribe individualized HEN to each patient, together with educational measures and training in the proper use of this treatment for both patients and trainers, improves nutritional status and reduces the onset of adverse events.

Identifiants

pubmed: 37218015
doi: 10.1186/s41043-023-00384-4
pii: 10.1186/s41043-023-00384-4
pmc: PMC10202059
doi:

Types de publication

Multicenter Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

45

Informations de copyright

© 2023. The Author(s).

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Auteurs

Adela Madrid-Paredes (A)

Servicio Farmacia Hospitalaria, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada, Av. del Conocimiento, s/n, 18016, Granada, Spain. adelamadridparedes@gmail.com.

Socorro Leyva-Martínez (S)

Unidad de Nutrición Clínica y Dietética, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada, Av. del Conocimiento, s/n, 18016, Granada, Spain.

Verónica Ávila-Rubio (V)

Unidad de Nutrición Clínica y Dietética, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada, Av. del Conocimiento, s/n, 18016, Granada, Spain.

Juan Bautista Molina-Soria (JB)

Unidad de Nutrición Clínica y Dietética, Hospital Universitario San Agustín, AGS Norte de Jaén en Linares (Jaén), Av. San Cristóbal, 2D, 23700, Linares, Jaén, Spain.

Patricia Sorribes-Carrera (P)

Unidad de Nutrición Clínica y Dietética, Consorcio Hospitalario Provincial de Castellón, Avda. Dr. Clará 19 (704,29 km), 12002, Castellón de La Plana, Spain.

Carmen Yeste-Doblas (C)

Unidad de Nutrición Clínica y Dietética, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitaria de Granada, Av. del Conocimiento, s/n, 18016, Granada, Spain.

José Antonio López-Medina (JA)

Unidad de Nutrición Clínica y Dietética, Hospital Universitario Virgen de la Victoria, Campus de Teatinos, s/n, 29010, Málaga, Spain.

Victoria Eugenia Luna-López (VE)

Unidad de Nutrición Clínica y Dietética, Hospital Universitario Virgen de las Nieves, Av. de las Fuerzas Armadas, 2, 18014, Granada, Spain.

María Luisa Fernández-Soto (ML)

Departamento de Medicina, Facultad de Medicina, Av. de la Investigación, 11, 18016, Granada, Spain.

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