EFFECT, The Nordic Kitchen, Herlev University Hospital, Herlev, Denmark.
Clin Rehabil. 2013 Jun;27(6):483-93. doi: 10.1177/0269215512469384. Epub 2012 Dec 20.
To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.
Twelve-week single-blind randomized controlled study.
Geriatric medical patients (65+ years) at nutritional risk.
Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented with three follow-up visits by general practitioners or three follow-up visits by general practitioners alone.
Primary outcome was risk of re-admissions. Secondary outcomes were functional status (hand grip strength, chair stand, mobility, disability and tiredness in daily activities, rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality.
One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks. Ten per cent of the participants had three contacts with their general practitioner, while compliance with the dietetic intervention was almost 100%. Odds ratio for re-admission and mortality after 26 weeks was 1.62 (95% confidence interval (CI) 0.85 to 3.10) and 0.60 (95% CI 0.17 to 2.13). The intervention had a positive effect on functional status (i.e. mobility, P = 0.029), and nutritional status (i.e. weight, P = 0.035; energy intake, P < 0.001; protein intake, P = 0.001) and the use of meals-on wheels was reduced (P = 0.084).
Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge.
评估出院后由注册营养师对老年患者家庭进行个体化营养咨询的额外益处，包括再入院风险、功能状态、营养状况、社会服务利用和死亡率。
为期 12 周的单盲随机对照研究。
营养风险的老年内科患者（65 岁以上）。
参与者被随机分配接受家庭访问，一组接受由注册营养师进行的三次个体化营养咨询，并辅以三次全科医生随访，另一组仅接受三次全科医生随访。
主要结局是再入院风险。次要结局是功能状态（手握力、坐站、活动能力、日常生活中的残疾和疲劳、康复能力）、营养状况（体重、BMI、能量和蛋白质摄入）、社会服务需求（家庭护理、家庭护理、上门送餐）和死亡率。
共纳入 152 例患者；132 例（87%）完成了第 1 次和 124 例（82%）在 12 周后完成了第 2 次数据收集。10%的参与者与全科医生进行了三次接触，而饮食干预的依从性几乎达到 100%。26 周时再入院和死亡率的比值比分别为 1.62（95%置信区间（CI）0.85 至 3.10）和 0.60（95%CI 0.17 至 2.13）。该干预措施对功能状态（即活动能力，P = 0.029）和营养状态（即体重，P = 0.035；能量摄入，P < 0.001；蛋白质摄入，P = 0.001）有积极影响，并减少了上门送餐的使用（P = 0.084）。
出院后由注册营养师进行家庭随访对老年内科患者的功能和营养状况有积极影响。
