Servicio Endocrinología y Nutrición, Complejo Hospitalario Universitario de Santiago de Compostela, A Coruña, Santiago de Compostela, Spain.
Nestlé Health Science, Barcelona, Spain.
Nutr Clin Pract. 2022 Aug;37(4):878-886. doi: 10.1002/ncp.10811. Epub 2021 Dec 13.
Appropriate patient/caregiver training and continuity of care after hospital discharge are key factors for the success of home enteral nutrition (HEN). This study aims to assess the effects of a specific patient support program (PSP) on the nutrition status, health-related quality of life (HRQoL), and healthcare resource utilization and associated costs of patients with HEN.
Observational study of adult patients with HEN enrolled in a PSP. Sociodemographic variables (baseline), HRQoL (NutriQoL) and nutrition status (Mini Nutritional Assessment [MNA]) (baseline, 6 months after PSP enrollment), and use of unplanned HEN-related healthcare resources (6 months prior to or after PSP enrollment) were recorded. HEN-related resource cost was estimated from total resources used (all patients) and each resource cost. Data were analyzed with Stata program (v. 14), considering P < 0.05 as significant.
Forty-three patients were included in the study (mean age, 72 years [SD = 21]; 54% women; mean HEN duration, 4 years [SD = 5]). A total of 401 calls were recorded in the PSP, 7% made proactively by the patient. HRQoL and nutrition status remained stable during the study period (NutriQoL baseline, 64; 6-months, 66; P = 0.3737; MNA baseline, 10; 6-months, 10; P = 0.0675). Unplanned resources amounted to €6229 (US $5563) and €4711 (US $4207) before and after PSP enrollment, respectively. Cost savings, representing €1518 (US $1356), were related to fewer emergency visits.
Health advice provided through a PSP and close patient monitoring in the hospital can help to maintain patients' nutrition status and HRQoL and to reduce the use of certain unplanned HEN-related resources, leading to cost savings.
适当的患者/照护者培训和出院后的连续性护理是家庭肠内营养（HEN）成功的关键因素。本研究旨在评估特定的患者支持计划（PSP）对 HEN 患者的营养状况、健康相关生活质量（HRQoL）以及医疗保健资源利用和相关成本的影响。
对参与 PSP 的 HEN 成年患者进行观察性研究。记录人口统计学变量（基线）、HRQoL（NutriQoL）和营养状况（Mini Nutritional Assessment [MNA]）（基线、PSP 注册后 6 个月）以及计划外 HEN 相关医疗保健资源的使用情况（PSP 注册前或后 6 个月）。HEN 相关资源成本是根据总资源使用量（所有患者）和每种资源成本计算得出的。使用 Stata 程序（v.14）进行数据分析，认为 P < 0.05 具有统计学意义。
本研究共纳入 43 例患者（平均年龄 72 岁[标准差=21]；54%为女性；HEN 持续时间平均为 4 年[标准差=5]）。在 PSP 中记录了 401 次通话，其中 7%是患者主动拨打的。在研究期间，HRQoL 和营养状况保持稳定（NutriQoL 基线为 64；6 个月时为 66；P=0.3737；MNA 基线为 10；6 个月时为 10；P=0.0675）。PSP 注册前后未计划的资源分别为 6229 欧元（5563 美元）和 4711 欧元（4207 美元）。与 PSP 注册前相比，节省了 1518 欧元（1356 美元），这与急诊就诊次数减少有关。
通过 PSP 提供健康建议和在医院密切监测患者可以帮助维持患者的营养状况和 HRQoL，并减少某些计划外 HEN 相关资源的使用，从而节省成本。
