TY - JOUR

T1 - Individual nutritional intervention for prevention of readmission among geriatric patients - a randomized controlled pilot trial

AU - Cramon, Mai Østerø

AU - Raben, Ines

AU - Beck, Anne Marie

AU - Andersen, Jens Rikardt

N1 - © 2021. The Author(s).

PY - 2021

Y1 - 2021

N2 - Background: Approximately 20% of older people are readmitted to the hospital within 30 days of discharge. Even a short hospital stay decreases the ability to cope with the activities of daily living. The aims of this study were to (1) assess the feasibility of recruitment, (2) assess the acceptability of the intervention, and (3) investigate if an individual nutritional intervention could reduce the readmission rate of geriatric patients within 30 days of being discharged to their own homes.Methods: The unblinded, randomized, controlled pilot trial includes geriatric patients discharged to their own homes. Forty patients were recruited from a medical ward and randomized to standard treatment (n = 19) or individualized nutritional intervention (n = 21). The intervention was dietary counseling and a nutrition plan before discharge, combined with two home visits performed by an educated nutritionist over a period of 4 weeks. Outcomes were readmission (primary), mortality, protein and energy intake, body weight, activity of daily living, handgrip strength, number of chair stands, and quality of life. Intention-to-treat analysis, per-protocol analysis, and post hoc analysis of readmissions were carried out.Results: Recruitment was feasible, and there was high compliance to the intervention. There was no difference in readmission between the intervention group and control group 30 days after discharge (29% vs 11%). The individual nutritional intervention had a positive impact on achieving 75% of energy requirements at 30 days for the intervention group compared to the control group (93% vs 47%, p = 0.01). No other differences were found between the groups.Conclusion: The individual nutritional intervention did not prevent readmission among geriatric patients in this trial. Recruitment procedures functioned well, and the intervention was well accepted by the patients.Trial registration: ClinicalTrial.gov, NCT03519139 . Retrospectively registered on 8 May 2018.

AB - Background: Approximately 20% of older people are readmitted to the hospital within 30 days of discharge. Even a short hospital stay decreases the ability to cope with the activities of daily living. The aims of this study were to (1) assess the feasibility of recruitment, (2) assess the acceptability of the intervention, and (3) investigate if an individual nutritional intervention could reduce the readmission rate of geriatric patients within 30 days of being discharged to their own homes.Methods: The unblinded, randomized, controlled pilot trial includes geriatric patients discharged to their own homes. Forty patients were recruited from a medical ward and randomized to standard treatment (n = 19) or individualized nutritional intervention (n = 21). The intervention was dietary counseling and a nutrition plan before discharge, combined with two home visits performed by an educated nutritionist over a period of 4 weeks. Outcomes were readmission (primary), mortality, protein and energy intake, body weight, activity of daily living, handgrip strength, number of chair stands, and quality of life. Intention-to-treat analysis, per-protocol analysis, and post hoc analysis of readmissions were carried out.Results: Recruitment was feasible, and there was high compliance to the intervention. There was no difference in readmission between the intervention group and control group 30 days after discharge (29% vs 11%). The individual nutritional intervention had a positive impact on achieving 75% of energy requirements at 30 days for the intervention group compared to the control group (93% vs 47%, p = 0.01). No other differences were found between the groups.Conclusion: The individual nutritional intervention did not prevent readmission among geriatric patients in this trial. Recruitment procedures functioned well, and the intervention was well accepted by the patients.Trial registration: ClinicalTrial.gov, NCT03519139 . Retrospectively registered on 8 May 2018.

KW - Faculty of Science

KW - Readmission

KW - Nutritional counseling

KW - Home visits after discharge

U2 - 10.1186/s40814-021-00926-9

DO - 10.1186/s40814-021-00926-9

M3 - Journal article

C2 - 34782015

VL - 7

JO - Pilot and Feasibility Studies

JF - Pilot and Feasibility Studies

SN - 2055-5784

M1 - 206

ER -