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. 2025 Jan 10;17(2):240.
doi: 10.3390/nu17020240.

Interdisciplinary Oral Nutrition Support and Supplementation After Hip Fracture Surgery in Older Adult Inpatients: A Global Cross-Sectional Survey (ONS-STUDY)

Jack Bell  1   2 , Ruqayyah Turabi  3   4 , Sissel Urke Olsen  5 , Katie Jane Sheehan  3   6 , Ólöf Guðný Geirsdóttir  2
Affiliations

Interdisciplinary Oral Nutrition Support and Supplementation After Hip Fracture Surgery in Older Adult Inpatients: A Global Cross-Sectional Survey (ONS-STUDY)

Jack Bell et al. Nutrients. .

Abstract

Background: Malnutrition predicts poor outcomes following hip fracture, affecting patient recovery, healthcare performance, and costs. Evidence-based guidelines recommend multicomponent, interdisciplinary nutrition care to improve intake, reduce complications, and enhance outcomes. This study examines global variation in oral nutrition support for older (65+ years) hip fracture inpatients.

Methods: A global survey was conducted as part of a broader program to improve interdisciplinary nutrition care. The protocol was based on evidence-based guidelines, reviewed by experts, and piloted for validity. Recruitment used snowball sampling to achieve diversity across income levels, countries, and healthcare roles.

Results: The survey (July-September 2023) recruited 308 participants from 46 countries across five global regions. Respondents primarily worked in acute teaching (57.5%) and non-teaching (17.5%) hospitals, representing medical (48.4%), nursing (28.2%), and allied health (17.9%) roles. Findings revealed a global knowledge-to-practice gap in multicomponent nutrition care, across providing high-protein/energy food and fluids (median: "half the time"), post-operative provision of oral nutritional supplements (median: "half the time") and continuation for one month with assessment (median: "not very often"), and nutritional education (median: "not very often"). Only 17.9% of respondents reported routine provision ("often" and "nearly always or always") of high-protein/energy food, supplements, and education. Substantial regional variation showed Western Pacific respondents perceiving the lowest provision across multicomponent processes. Interdisciplinary, multicomponent interventions were seen as a potential opportunity requiring further exploration.

Conclusions: Major gaps persist in implementing evidence-based, interdisciplinary, multicomponent nutrition care for older adults with hip fractures. A targeted implementation approach is the next step to addressing the knowledge-to-practice gap.

Keywords: hip fractures; hospitals; malnutrition; nutrition risk assessment; nutritional support; oral nutrition supplements.

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Conflict of interest statement

All authors are members of the Fragility Fracture Network (FFN). FFN is a not-for-profit organization that receives industry partner funding and support, including from Nutricia.

Figures

Figure 1
Figure 1
Participant responses to Likert scale questions on nutrition care practices for older adults with hip fractures.
See this image and copyright information in PMC

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