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Use of oral supplements in malnourished elderly patients living in the community: a pharmaco-economic study.
Clin Nutr. 2004 Oct; 23(5):1096-103.CN

Abstract

BACKGROUND & AIMS

Inadequate nutritional support in elderly patients is likely to be responsible for increased morbidity and increased associated costs. Conversely prescribing oral supplements to ensure sufficient protein and energy intake should be beneficial. Even though this claim makes sense there is a lack of objective data to support the evidence. The objective of the present study was to assess the cost of malnutrition and related comorbidities among elderly patients living in the community and to determine the impact of nutritional support practice on these outcomes.

METHODS

Observational, prospective, longitudinal, cohort study with a 12 months follow-up conducted with 90 general practitioners in France. Two groups of physicians were selected based on historical prescribing practice: group 1 with rare and group 2 with frequent prescription of oral nutrition supplements. The resulting study population was 378 elderly malnourished patients aged over 70, living in the community, either at home or in institutions. Nutritional status at baseline was determined using the Mini Nutritional Assessment (MNA) scale. Main outcome measures were nutritional status, malnutrition-related comorbidities and medical care consumption.

RESULTS

Populations in the two groups of patients were balanced for age, gender, weight and body mass index but differed significantly in terms of housing status (P < 0.005) and nutritional status (P < 0.001). After adjustment for baseline characteristics, MNA improved within both groups over time but improvement was significantly higher in group 2 than in group 1 (P < 0.01). The adjusted cost per patient of hospital care (EUR -551), nursing care (EUR -145) and other medical care was significantly reduced in group 2 as compared to group 1, with cost savings of EUR -723 per patient (90% CI: EUR -1.444 to EUR -43). Including the costs related to nutritional products, the total cost savings per patient attributable to nutrition support were EUR -195 (90% CI: EUR -929 to EUR +478).

CONCLUSION

Appropriate nutrition support can address the problem of malnutrition among elderly individuals living in the community and may contribute to reduce the costs of health care.

Authors+Show Affiliations

Nestlé Clinical Nutrition, Noisiel, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15380901

Citation

Arnaud-Battandier, F, et al. "Use of Oral Supplements in Malnourished Elderly Patients Living in the Community: a Pharmaco-economic Study." Clinical Nutrition (Edinburgh, Scotland), vol. 23, no. 5, 2004, pp. 1096-103.
Arnaud-Battandier F, Malvy D, Jeandel C, et al. Use of oral supplements in malnourished elderly patients living in the community: a pharmaco-economic study. Clin Nutr. 2004;23(5):1096-103.
Arnaud-Battandier, F., Malvy, D., Jeandel, C., Schmitt, C., Aussage, P., Beaufrère, B., & Cynober, L. (2004). Use of oral supplements in malnourished elderly patients living in the community: a pharmaco-economic study. Clinical Nutrition (Edinburgh, Scotland), 23(5), 1096-103.
Arnaud-Battandier F, et al. Use of Oral Supplements in Malnourished Elderly Patients Living in the Community: a Pharmaco-economic Study. Clin Nutr. 2004;23(5):1096-103. PubMed PMID: 15380901.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of oral supplements in malnourished elderly patients living in the community: a pharmaco-economic study. AU - Arnaud-Battandier,F, AU - Malvy,D, AU - Jeandel,C, AU - Schmitt,C, AU - Aussage,P, AU - Beaufrère,B, AU - Cynober,L, PY - 2003/08/14/received PY - 2004/02/10/accepted PY - 2004/9/24/pubmed PY - 2005/4/9/medline PY - 2004/9/24/entrez SP - 1096 EP - 103 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 23 IS - 5 N2 - BACKGROUND & AIMS: Inadequate nutritional support in elderly patients is likely to be responsible for increased morbidity and increased associated costs. Conversely prescribing oral supplements to ensure sufficient protein and energy intake should be beneficial. Even though this claim makes sense there is a lack of objective data to support the evidence. The objective of the present study was to assess the cost of malnutrition and related comorbidities among elderly patients living in the community and to determine the impact of nutritional support practice on these outcomes. METHODS: Observational, prospective, longitudinal, cohort study with a 12 months follow-up conducted with 90 general practitioners in France. Two groups of physicians were selected based on historical prescribing practice: group 1 with rare and group 2 with frequent prescription of oral nutrition supplements. The resulting study population was 378 elderly malnourished patients aged over 70, living in the community, either at home or in institutions. Nutritional status at baseline was determined using the Mini Nutritional Assessment (MNA) scale. Main outcome measures were nutritional status, malnutrition-related comorbidities and medical care consumption. RESULTS: Populations in the two groups of patients were balanced for age, gender, weight and body mass index but differed significantly in terms of housing status (P < 0.005) and nutritional status (P < 0.001). After adjustment for baseline characteristics, MNA improved within both groups over time but improvement was significantly higher in group 2 than in group 1 (P < 0.01). The adjusted cost per patient of hospital care (EUR -551), nursing care (EUR -145) and other medical care was significantly reduced in group 2 as compared to group 1, with cost savings of EUR -723 per patient (90% CI: EUR -1.444 to EUR -43). Including the costs related to nutritional products, the total cost savings per patient attributable to nutrition support were EUR -195 (90% CI: EUR -929 to EUR +478). CONCLUSION: Appropriate nutrition support can address the problem of malnutrition among elderly individuals living in the community and may contribute to reduce the costs of health care. SN - 0261-5614 UR - https://www.unboundmedicine.com/medline/citation/15380901/Use_of_oral_supplements_in_malnourished_elderly_patients_living_in_the_community:_a_pharmaco_economic_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261561404000275 DB - PRIME DP - Unbound Medicine ER -