The Effect of Nutrition Follow up After Hospital Discharge in Undernourished Elderly

The Effect of Follow up on Nutrition Intervention After Discharge in Undernourished Geriatric Patients

The purpose of this study is to test two different interventions of nutrition follow up after discharge from geriatric ward in undernourished geriatric patients. The patients are randomized to a home visit arm, a telephone consultation arm, or a control arm. Patients in the home visit arm and their home care helper will get visits from a clinical dietician at one week, two weeks and four weeks after discharge, in order to follow up on the nutrition intervention. Patients in the telephone consultation arm and their home care helper will be contacted by a clinical dietician at one week, two weeks and four weeks after discharge, in order to follow up on the nutrition intervention. The control arm will not be contacted.

The primarily outcome is functional ability. Secondary outcomes are quality of life, readmission and mortality.

Study Overview

• Status: Completed
• Conditions: Under Nutrition
• Intervention / Treatment: Other: Home visit; Other: Telephone consultation

Detailed Description

Under nutrition among geriatric patients is a recurrent and well documented problem. Up to 55 % of the elderly are undernourished at the time of admission. Hospitalisation and acute illness are associated to loss of muscles and physical ability, complications, dependency, morbidity and mortality. Elderly who live alone are more vulnerable to nutritional problems, than elderly who live together with another person or in a nursing home. Geriatric patients, who are admitted to geriatric ward Aarhus University Hospital due to various acute somatic disorders, aged 75 and older and who are living alone with help from the home care facilities can participate in the study. According to the power calculation 150 patients must be included, 50 patients in each arm of the study. Informed consent will be obtained before inclusion and discharge from hospital. Randomization will be computerised and determine if the patient will be allocated to the "home visit" group, the "telephone consultation" group or the "control group". Patients who suffer from mental disorder (MMSE<22) or active cancer are excluded as well as patients who live together with another person or live in a nursing home. During hospitalisation the three groups will receive the same nutritional care as all patients in nutritional risk. This includes nutritional intervention during hospitalization and an individual diet plan at discharge. Patients in the home visit arm will get visits from a clinical dietician at one week, two weeks and four weeks after discharge. Patients in the telephone consultation arm will be contacted by a clinical dietician at one week, two weeks and four weeks after discharge. In both intervention groups the patients and their home care helpers will get dietary advice and follow up on their individual diet plan. The main outcome is functional ability from discharge and to 8 weeks after discharge. Secondary outcomes are quality of life, readmission at 30 and 90 days and mortality at 30 and 90 days.

• Study Type: Interventional
• Enrollment (Actual): 208
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Denmark
  • Aarhus, Denmark, 8000
    • Aarhus Universityhospital, Geriatric Department
  • Aarhus, Denmark, 8000
    • geriatric Department

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 75 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• aged 75 and over
• undernourished according to Mini Nutritional Assessment (MNA)
• living alone in own home
• admitted and discharged from geriatric ward Aarhus, Denmark, due to various acute somatic disorders

Exclusion Criteria:

• active cancer
• mental disorder (MMSE<22)
• live together with another person
• live in a nursing home

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Home visits; Nutritional follow-up after discharge, conducted as nutritional counselling performed as in-person counselling in the participants homes	Other: Home visit; Patients and their homecare helper will receive visits from a clinical dietician 1 week, 2 weeks and 4 weeks after discharge. The purpose of the visits is follow up on the individual diet plan distributed at discharge and supply dietary advice.; Other Names: Aged 75 and over; Living alone; Receive help for home care services; Dietary advice after discharge by home visits
Experimental: Telephone consultation; Nutritional follow-up after discharge, conducted as nutritional counselling performed as telephone consultation	Other: Telephone consultation; Patients and their homecare helper will be contacted on telephone from a clinical dietician 1 week, 2 weeks and 4 weeks after discharge. The purpose of the telephone contact is follow up on the individual diet plan distributed at discharge and supply dietary advice.; Other Names: Aged 75 and over; Living alone; Receive help for home care services; Dietary advice after discharge by telephone consultation
No Intervention: Control; No follow-up after discharge

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional ability.	Measurements: Barthel-100 Index, Cumulated Ambulation Score (CAS), handgrip strength, part of senior fitness test,fatigue test (Avlund)	Between discharge and 8 weeks after discharge

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of Life	Measurements: SF-36, geriatric depression score (GDS), depression list (DL)	Between discharge and 8 weeks after discharge
Mortality		Between discharge and 30 after discharge
Readmission to hospital		Between discharge and 30 days after discharge
Readmission		Between discharge and 90 days after discharge
Mortality		Between discharge and 90 days after discharge

Collaborators and Investigators

• Sponsor: Aarhus University Hospital
• Investigators: Principal Investigator: Jette Lindegaard Pedersen, MHSc., Aarhus University Hospital; Study Chair: Else Marie S. Damsgaard, Professor, Aarhus University Hospital; Study Chair: Preben Ulrich Pedersen, Ph.D., University of Aarhus

Study record dates

Study Major Dates

• Study Start: June 1, 2011
• Primary Completion (Actual): January 1, 2014
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: April 28, 2011
• First Submitted That Met QC Criteria: April 28, 2011
• First Posted (Estimate): April 29, 2011

Study Record Updates

• Last Update Posted (Estimate): December 31, 2015
• Last Update Submitted That Met QC Criteria: December 30, 2015
• Last Verified: December 1, 2015

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nutrition Disorders; Malnutrition
• Other Study ID Numbers: 23012011