Nutritional treatment after discharge of older patients at nutritional risk: A single-arm feasibility study

Abstract

Background

Malnutrition is common among older hospitalized patients and is linked to poor outcomes. While the transition between healthcare sectors is important for ensuring adequate nutrition, nutritional interventions have not been effectively implemented. This study aimed to evaluate the feasibility of the study design in older patients at nutritional risk following hospital discharge, focusing on eligibility, recruitment, retention, and data collection.

Methods

This feasibility study was conducted at Copenhagen University Hospital Herlev and Gentofte for a period of three months. Older patients at nutritional risk who were discharged with the liaison team received a food package that covered their nutritional requirements for 24 hours, along with individualized nutritional counselling provided at 2–4 days and 30 days post-discharge. The primary outcome was feasibility, assessed as eligibility, recruitment, retention, feasibility of data collection, and overall study design. The secondary outcome was compliance with nutritional counselling.

Results

Of 76 screened patients, 100% were eligible for participation. A total of 62 (82%) patients met the inclusion criteria and none of the exclusion criteria. During the study period, 31 (79%) accepted to participate, reflecting an inclusion rate of 1.8 patients/week. Retention in the study was 73%. Overall, data collection completeness at baseline exceeded 80%, except for three measures: nutritional risk screening by hospital staff, clinical frailty scale, and performance of 30-second chair stand test. From day 2–4 to day 30, there was an increase in the proportion of patients achieving ≥75% of their estimated requirement for energy (P=0.008) and protein (P=0.014).

Conclusion

Overall, the study design demonstrated that the intervention was feasible. We found high eligibility, data completeness, and compliance with the nutritional counselling in relation to energy and protein intake. However, the recruitment rate and retention in the study was lower than expected. Recruiting and retaining this nutritionally vulnerable group of older patients was challenging, and efforts must be made to secure higher retention as well as an improved recruitment strategy.