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Other Hospital Pharmacy topics (including: medical devices)
Nutritional assessment of institutionalised older patients taking nutritional supplementation
  1. A. Morego Soler,
  2. A. Boso Ribelles,
  3. M. Tobaruela Soto,
  4. P. Molina Guillen,
  5. B. Arribas Diaz
  1. 1Hospital Morales Meseguer, Hospital Pharmacy, Murcia, Spain

Abstract

Background Pharmacist's role in a social-health centre is very wide. Control of nutritional supplementation is sometimes forgotten.

Purpose Nutritional status evaluation and follow-up of institutionalised older patients taking enteral nutrition.

Materials and methods Cross-sectional and longitudinal study in institutionalised older patients at a social-health centre. The authors selected patients who were receiving nutritional supplements in two wards of the centre. Patients were weighed and classified according to body mass index (BMI), and albumin values were requested. A protocol was prepared to evaluate them nutritionally. The classification according to BMI was: overweight, normal, potential risk of malnutrition, slight, moderate or severe malnutrition and according to albumin: mild, moderate, and severe malnutrition. Patients with moderate-severe malnutrition underwent a complete nutritional assessment (day intake record and fold measurement). The recommendations were: withdraw, replace, or continue with the supplement according to the needs of the older patients and their acceptance was recorded. Reevaluation was quarterly

Results Thirty-eight older patients were included with a mean age of 85 years. Six of them died. By BMI: 4 were overweight, 8 had normal BMI, 12 had possible malnutrition, 1 mild malnutrition, 2 moderate and 5 severe malnutrition. 37.5% had albumin levels indicative of mild malnutrition and 3% of moderate malnutrition. Three months later, 21 patient were reevaluated: 7 increased BMI (6 at risk of malnutrition), 8 decreased and 6 remained unchanged. 78% of patients had normal serum albumin levels and 22% had mild protein malnutrition. A total of 21 interventions were made, 18 were accepted and 3 rejected. Nine of them were proposals to discontinue

Conclusions Nutritional supplementation resulted in albumin levels normalisation, but was not such effective in terms of BMI changes. The authors noticed overutilisation of nutritional supplements and the need of a nutritional assessment protocol in the social-health setting

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