The dossier, entitled ‘Better care through better nutrition: value and effects of medical nutrition,’ is The Medical Nutrition International’s (MNI) evidence-based publication covering aspects of medical nutrition.
“Malnutrition continues to go undetected and untreated. This affects people’s lives and poses a significant burden on the healthcare economy. However malnutrition is treatable,” explained Léa Coulet, executive director of the MNI.
Current estimates identify 33 million adults across Europe as malnourished or at risk of developing malnutrition, with this number expected to increase in line with an ageing population.
The elderly and those admitted to hospital are particularly vulnerable with 1 in 4 patients and 1 in 3 older people living independently are malnourished or at risk of malnutrition. On average, hospital stay for the malnourished increase in length by 30%.
The estimated cost of managing malnourished patients or at risk of malnutrition is €170bn across Europe with patient treatment for malnutrition around 2-3 times greater than for a non-malnourished patient.
Updated and expanded report
“A growing body of evidence demonstrates the benefits of medical nutrition in addressing malnutrition,” added Coulet.
“These are summarised in the Dossier. We hope it will help to better integrate nutritional care in disease management for the benefit of patients and healthcare systems.”
As well as guidelines and recommendations to address enteral tube feeding (ETF), the report—an updated and expanded version of previous reports prepared in 2009, 2010 and 2012—also covers other aspects of medical nutrition from oral nutrition supplementation (ONS) to parenteral nutrition.
The report also devotes much consideration to clinical evidence that points to ONS as an effective solution for patients able to consume normal food but not enough to meet nutritional requirements.
“Taking this treatment route leads to weight gain, reductions in mortality, reductions in complication rates and reductions in the proportion of patients admitted or readmitted to hospital,” the authors state.
The MNI is made up of six members that include Abbott, Baxter, B.Braun, Fresenius-Kabi, Nestlé Health Science and Nutricia Advanced Medical Nutrition.
Working alongside the European Nutrition for Health Alliance (ENHA), the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Union Geriatric Medicine Society (EUGMS) amongst others, there was broad consensus that guidelines must be updated regularly to reflect the evidence base.
This was also to ensure the integration of good nutritional care into guidelines for specific diseases (e.g. nutritional support as part of cancer care guidelines), and to ensure that these guidelines are embedded in practice.
They added that consideration should be given to innovative ways to facilitate the sharing of good practice at local, national and international level.
Its recommendations included ways to identify malnutrition, its prevalence, causes and consequences through a series of screening, education and arming practitioners practical advice about how and when to use different forms of nutritional intervention.
“There must be multi-stakeholder involvement at all levels,” the report urged.
“Awareness, training and education are central to success, that audit and quality improvement activities should be included in any initiative that strives to tackle malnutrition and that good practice should be routinely shared.”
The MNI’s report can be accessed here.