Norwegian National Advisory Unit on Disease Related Undernutrition, Division of Cancer Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway; Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Box 1110 Blindern, 0317 Oslo, Norway.
Norwegian National Advisory Unit on Disease Related Undernutrition, Division of Cancer Medicine, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.
Clin Nutr. 2020 Dec;39(12):3607-3617. doi: 10.1016/j.clnu.2020.03.012. Epub 2020 Mar 19.
BACKGROUND & AIMS: Compliance to guidelines for disease-related malnutrition is documented as poor. The practice of using paper-based dietary recording forms with manual calculation of the patient's nutritional intake is considered cumbersome, time-consuming and unfeasible among the nurses and does often not lead to appropriate nutritional treatment. We developed the digital decision support system MyFood to deliver a solution to these challenges. MyFood is comprised of an app for patients and a website for nurses and includes functions for dietary recording, evaluation of intake compared to requirements, and a report to nurses including tailored recommendations for nutritional treatment and a nutritional care plan for documentation. The study aimed to investigate the effects of using the MyFood decision support system during hospital stay on adult patients' nutritional status, treatment and hospital length of stay. The main outcome measure was weight change. METHODS: The study was a parallel-arm randomized controlled trial. Patients who were allocated to the intervention group used the MyFood app during their hospital stay and the nurses were encouraged to use the MyFood system. Patients who were allocated to the control group received routine care. RESULTS: We randomly assigned 100 patients (51.9 ± 14 y) to the intervention group (n = 49) and the control group (n = 51) between August 2018 and February 2019. Losses to follow-up were n = 5 in the intervention group and n = 1 in the control group. No difference was found between the two groups with regard to weight change. Malnutrition risk at discharge was present in 77% of the patients in the intervention group and 94% in the control group (p = 0.019). Nutritional treatment was documented for 81% of the patients in the intervention group and 57% in the control group (p = 0.011). A nutritional care plan was created for 70% of the intervention patients compared to 16% of the control patients (p < 0.001). CONCLUSIONS: The intervention had no effect on weight change during hospital stay. A higher proportion of the patients in the control group was malnourished or at risk of malnutrition at hospital discharge compared to the patients in the intervention group. The documentation of nutritional intake, treatment and nutritional care plans was higher for the patients using the MyFood system compared to the control group. This trial was registered at clinicaltrials.gov (NCT03412695).
背景与目的：据记录，疾病相关营养不良的指南遵循情况较差。使用纸质饮食记录表格并手动计算患者营养摄入量的做法被认为繁琐、耗时且不可行，这往往无法导致适当的营养治疗。我们开发了数字决策支持系统 MyFood 来解决这些挑战。MyFood 包括一个面向患者的应用程序和一个面向护士的网站，其中包括饮食记录、评估摄入量与需求的对比以及向护士报告的功能，其中包括针对营养治疗的定制建议和营养护理计划文档。本研究旨在调查在住院期间使用 MyFood 决策支持系统对成年患者营养状况、治疗和住院时间的影响。主要观察指标是体重变化。
方法：该研究为平行臂随机对照试验。被分配到干预组的患者在住院期间使用 MyFood 应用程序，并且鼓励护士使用 MyFood 系统。被分配到对照组的患者接受常规护理。
结果：我们在 2018 年 8 月至 2019 年 2 月期间随机分配了 100 名（51.9±14 岁）患者（n=49）至干预组和对照组（n=51）。干预组的失访人数为 n=5，对照组为 n=1。两组患者的体重变化无差异。干预组出院时存在营养不良风险的患者占 77%，对照组占 94%（p=0.019）。干预组有 81%的患者记录了营养治疗，对照组为 57%（p=0.011）。与对照组相比，70%的干预患者创建了营养护理计划，而对照组为 16%（p<0.001）。
结论：干预措施对住院期间的体重变化没有影响。与干预组相比，对照组出院时营养不良或有营养不良风险的患者比例更高。与对照组相比，使用 MyFood 系统的患者的营养摄入量、治疗和营养护理计划的记录比例更高。该试验在 clinicaltrials.gov 注册（NCT03412695）。
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