Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2015 Mar;19(3):356-64.
doi: 10.1007/s12603-014-0544-y.

Compliance of nursing home residents with a nutrient- and energy-dense oral nutritional supplement determines effects on nutritional status

I Jobse  1 , Y Liao, M Bartram, K Delantonio, W Uter, P Stehle, C C Sieber, D Volkert
Affiliations
Randomized Controlled Trial

Compliance of nursing home residents with a nutrient- and energy-dense oral nutritional supplement determines effects on nutritional status

I Jobse et al. J Nutr Health Aging. 2015 Mar.

Abstract

Objectives: Administration of oral nutritional supplements (ONS) is an effective strategy to treat and avoid malnutrition, a persisting issue in nursing homes. However, little is known about compliance in the NH population. This study aimed to analyse the effects of compliance of NH residents with a low-volume, nutrient- and energy-dense ONS on nutritional status and to identify residents' characteristics associated with compliance.

Design and setting: Randomized, controlled trial in nursing homes.

Participants and intervention: 87 nursing home residents (87 ± 6y, 91% female) with malnutrition or at risk of malnutrition were randomly allocated to an intervention group (IG) receiving 2 x 125 ml ONS (2.4 kcal/ml)/d for 12 weeks, or the control group (CG) with usual care.

Measurements: ONS intake was recorded daily and compliance calculated. Low and high compliance were defined as ≤ 30% and ≥ 80% of provided ONS actually consumed, respectively. Body weight (BW), BMI, upper-arm (UAC) and calf-circumference (CC) and MNA-SF were assessed at baseline and after 12 weeks. Associations between compliance and changes of nutritional parameters and residents' characteristics were analysed.

Results: Compliance was high in 35.7% and low in 28.6% of the IG (n=42). BW change was significantly higher in subjects with high compliance (median +3.0 (interquartile range +2.1;+3.8) kg, n=15) than in those with low compliance (-0.2 (-2.2;+1.6) kg, n=12) and CG (-0.1 (-1.2; +0.6) kg, n=35; p<0.001), and significantly correlated with compliance in IG (r=0.691; p<0.001). Significant differences and correlations were also identified for BMI, UAC and MNA-SF. High compliance was more often observed in residents with malnutrition (66.7 vs. 27.3%) and chewing difficulties (77.8 vs. 24.2%) than in those without these conditions. Low compliance was more prevalent in residents who were immobile (45.0 vs. 13.6%), depressed (33.3 vs. 6.7%) or had gastrointestinal complaints (50.0 vs. 17.9%) (all p<0.05).

Conclusions: A high compliance of nursing home residents with a low volume, nutrient- and energy dense ONS was related to a significantly improved nutritional status in comparison to low compliance and therefore enhanced the effectiveness of ONS. A higher compliance may be achieved by consideration of different residents' characteristics.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Boxplots of body weight change after 12 weeks (ΔT2-T1) in the control group (CG, n=35) and in different compliance groups of the intervention group (IG; ≤ 30%: n=12, >30- <80%: n=15, ≥80%: n=15)
Figure 2
Figure 2
Scatter plot of body weight change (ΔT2-T1) after 12 weeks in the intervention group (n=42)
See this image and copyright information in PMC

References

    1. Milne AC, Potter J, Vivanti A. Avenell A: Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev. 2009;2:003288. - PMC - PubMed
    1. Volkert D, Berner YN, Berry E, Cederholm T, Coti BP, Milne A, Palmblad J, Schneider S, Sobotka L, Stanga Z, et al. ESPEN Guidelines on Enteral Nutrition: Geriatrics. Clin Nutr. 2006;25(2):330–360. 10.1016/j.clnu.2006.01.012 PubMed PMID: 16735082. - DOI - PubMed
    1. Donini LM, Scardella P, Piombo L, Neri B, Asprino R, Proietti AR, Carcaterra S, Cava E, Cataldi S, Cucinotta D, et al. Malnutrition in elderly: social and economic determinants. J Nutr Health Aging. 2013;17(1):9–15. 10.1007/s12603-012-0374-8 PubMed PMID: 23299371. - DOI - PubMed
    1. Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony PS, Charlton KE, Maggio M, et al. Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc. 2010;58(9):1734–1738. 10.1111/j.1532-5415.2010.03016.x PubMed PMID: 20863332. - DOI - PubMed
    1. Stange I, Poeschl K, Stehle P, Sieber CC, Volkert D. Screening for malnutrition in nursing home residents: comparison of different risk markers and their association to functional impairment. J Nutr Health Aging. 2013;17(4):357–363. 10.1007/s12603-013-0021-z PubMed PMID: 23538659. - DOI - PubMed

Publication types