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Randomized Controlled Trial
. 2020 Feb 18;12(2):517.
doi: 10.3390/nu12020517.

Ready-Made Oral Nutritional Supplements Improve Nutritional Outcomes and Reduce Health Care Use-A Randomised Trial in Older Malnourished People in Primary Care

Trevor R Smith  1 , Abbie L Cawood  2 , Emily R Walters  3 , Natasha Guildford  4 , Rebecca J Stratton  2
Affiliations
Randomized Controlled Trial

Ready-Made Oral Nutritional Supplements Improve Nutritional Outcomes and Reduce Health Care Use-A Randomised Trial in Older Malnourished People in Primary Care

Trevor R Smith et al. Nutrients. .

Abstract

Large trials assessing oral nutritional supplements (ONS) and dietary advice (DA) in primary care are lacking. This study examined effects of ONS + DA versus DA on intake, weight, QoL, healthcare use and satisfaction in malnourished free-living older people. Three hundred and eight people (71.5 ± 10.7y) were randomised to receive ONS + DA (n154) or DA (n154) for 12 weeks. At baseline, 4, 8, 12 weeks, intake, weight, QoL, healthcare use and satisfaction were measured. ONS + DA group (mean daily intake ONS 480 kcal; 21 g protein; 80% compliance) had significantly greater total energy and protein intakes (+401 kcal/d, p < 0.001; +15 g/d, p < 0.001) and weight gain (+0.8 kg; p < 0.001) compared to DA. QoL improved in both groups over time with a significant improvement in index with ONS + DA (p = 0.009). Significantly more participants found ONS + DA made a difference for them (p = 0.011), but no differences were found between groups using Euroqol. Compared to DA, healthcare use reduced with ONS + DA, (HCP visits by 34%, emergency admissions 50%, LOS 62%). Acceptability of both interventions was high (ONS 96%, DA 95%), with significantly more participants satisfied with ONS (89%) than DA (73%) (p = 0.009). This trial in primary care indicates that ONS are acceptable, make a difference to patients, significantly improve intake and weight, and reduce health care use with potential savings.

Keywords: dietary advice; free living elderly; health care use; malnutrition; oral nutritional supplement.

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Conflict of interest statement

T.R.S. on behalf of the trial sponsor University Hospital Southampton NHS Foundation Trust received funding from NIHR and an unrestricted educational grant from Nutricia to support the study. E.R.W. is a voluntary member of the Department of Health Advisory Board for Borderline Substances. A.L.C. and R.J.S. both of whom hold honorary research posts with the University of Southampton, are also employed part time by Nutricia. N.G. declared no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of participants from screening to week 12 follow up visit. ONS, oral nutritional supplement. DA, dietary advice. MR, medium risk. HR, high risk.
Figure 2
Figure 2
(a) Mean daily energy intakes according to intervention group; (b) Mean daily protein intakes according to intervention group; Univariate analysis adjusted for the baseline value, MUST category, CCI, age and gender. Data presented as mean ± SE, * p < 0.001. 4 participants in the DA arm reported taking over the counter ONS contributing to their intake. DA, dietary advice. ONS, oral nutritional supplement.
See this image and copyright information in PMC

References

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