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基层医疗中的临床营养:欧洲临床营养和代谢学会立场文件

Clinical nutrition in primary care: ESPEN position paper.

作者信息

Krznarić Željko, Vranešić Bender Darija, Blaž Kovač Milena, Cuerda Cristina, van Ginkel-Res Annemieke, Hiesmayr Michael, Marinho Anibal, Mendive Juan, Monteiro Isabel, Pirlich Matthias, Musić Milanović Sanja, Kozjek Nada Rotovnik, Schneider Stephane, Chourdakis Michael, Barazzoni Rocco

机构信息

University of Zagreb, Zagreb School of Medicine, University Hospital Centre Zagreb, Department of Gastroenterology, Hepatology and Nutrition, Zagreb, Croatia.

Community Health Centre Ljubljana, Ljubljana, Slovenia; Department of Family Medicine, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia.

出版信息

Clin Nutr. 2024 Jun;43(6):1678-1683. doi: 10.1016/j.clnu.2024.02.017. Epub 2024 Feb 21.

Abstract

Primary care healthcare professionals (PCHPs) are pivotal in managing chronic diseases and present a unique opportunity for nutrition-related disease prevention. However, the active involvement of PCHPs in nutritional care is limited, influenced by factors like insufficient education, lack of resources, and time constraints. In this position paper The European Society for Clinical Nutrition and Metabolism (ESPEN) promotes the active engagement of PCHPs in nutritional care. We emphasize the importance of early detection of malnutrition by screening and diagnosis, particularly in all individuals presenting with risk factors such as older age, chronic disease, post-acute disease conditions and after hospitalization for any cause. ESPEN proposes a strategic roadmap to empower PCHPs in clinical nutrition, focusing on education, tools, and multidisciplinary collaboration. The aim is to integrate nutrition into medical curricula, provide simple screening tools for primary care, and establish referral pathways to address malnutrition systematically. In conclusion, we urge for collaboration with PCHP organizations to raise awareness, enhance nutrition skills, facilitate dietitian accessibility, establish multidisciplinary teams, and promote referral pathways, thereby addressing the underestimated clinical challenge of malnutrition in primary care.

摘要

基层医疗保健专业人员(PCHPs)在慢性病管理中起着关键作用,为营养相关疾病的预防提供了独特的契机。然而,PCHPs在营养护理方面的积极参与有限,受到教育不足、资源匮乏和时间限制等因素的影响。在本立场文件中,欧洲临床营养与代谢学会(ESPEN)倡导PCHPs积极参与营养护理。我们强调通过筛查和诊断早期发现营养不良的重要性,特别是在所有具有风险因素的个体中,如老年人、慢性病患者、急性病后状况以及因任何原因住院后的患者。ESPEN提出了一项战略路线图,以增强PCHPs在临床营养方面的能力,重点关注教育、工具和多学科协作。目标是将营养纳入医学课程,为基层医疗提供简单的筛查工具,并建立转诊途径以系统地解决营养不良问题。总之,我们敦促与PCHP组织合作,提高认识,增强营养技能,方便患者获得营养师服务,建立多学科团队,并促进转诊途径,从而应对基层医疗中被低估的营养不良临床挑战。

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