Department of Gastroenterology, Mailpoint 255, University Hospitals Southampton NHS Foundation Trust, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Institute of Human Nutrition, Faculty of Medicine, Mailpoint 113, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.
Nutrients. 2020 Feb 18;12(2):517. doi: 10.3390/nu12020517.
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, < 0.001; +15 g/d, < 0.001) and weight gain (+0.8 kg; < 0.001) compared to DA. QoL improved in both groups over time with a significant improvement in index with ONS + DA ( = 0.009). Significantly more participants found ONS + DA made a difference for them ( = 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%) ( = 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.
大型临床试验评估口服营养补充剂(ONS)和饮食建议(DA)在初级保健中的作用尚缺乏。本研究旨在探讨ONS+DA 与 DA 对营养状况不佳的自由生活的老年人的摄入量、体重、生活质量、医疗保健使用和满意度的影响。308 名(71.5±10.7 岁)参与者被随机分配接受 ONS+DA(n=154)或 DA(n=154)治疗 12 周。在基线、4 周、8 周和 12 周时,评估了摄入量、体重、生活质量、医疗保健使用和满意度。ONS+DA 组(平均每日 ONS 摄入 480 千卡;21 克蛋白质;80%的依从性)的总能量和蛋白质摄入量显著增加(+401 千卡/天,<0.001;+15 克/天,<0.001),体重增加(+0.8 公斤,<0.001),与 DA 组相比。两组的生活质量随着时间的推移都有所改善,ONS+DA 组的指数有显著改善(=0.009)。ONS+DA 组有更多的参与者认为其对他们有帮助(=0.011),但两组在 EuroQol 方面没有差异。与 DA 相比,ONS+DA 组的医疗保健使用减少(HCP 就诊减少 34%,急诊入院减少 50%,住院时间减少 62%)。两种干预措施的可接受性都很高(ONS 为 96%,DA 为 95%),ONS 的满意度(89%)显著高于 DA(73%)(=0.009)。这项初级保健中的试验表明,ONS 是可以接受的,对患者有帮助,显著改善摄入量和体重,减少医疗保健使用,并可能节省成本。