Individual nutritional intervention for prevention of readmission among geriatric patients-a randomized controlled pilot trial

Mai Østerø Cramon, Ines Raben, Anne Marie Beck, Jens Rikardt Andersen, Mai Østerø Cramon, Ines Raben, Anne Marie Beck, Jens Rikardt Andersen

Abstract

Background: Approximately 20% of older people are readmitted to the hospital within 30 days of discharge. Even a short hospital stay decreases the ability to cope with the activities of daily living. The aims of this study were to (1) assess the feasibility of recruitment, (2) assess the acceptability of the intervention, and (3) investigate if an individual nutritional intervention could reduce the readmission rate of geriatric patients within 30 days of being discharged to their own homes.

Methods: The unblinded, randomized, controlled pilot trial includes geriatric patients discharged to their own homes. Forty patients were recruited from a medical ward and randomized to standard treatment (n = 19) or individualized nutritional intervention (n = 21). The intervention was dietary counseling and a nutrition plan before discharge, combined with two home visits performed by an educated nutritionist over a period of 4 weeks. Outcomes were readmission (primary), mortality, protein and energy intake, body weight, activity of daily living, handgrip strength, number of chair stands, and quality of life. Intention-to-treat analysis, per-protocol analysis, and post hoc analysis of readmissions were carried out.

Results: Recruitment was feasible, and there was high compliance to the intervention. There was no difference in readmission between the intervention group and control group 30 days after discharge (29% vs 11%). The individual nutritional intervention had a positive impact on achieving 75% of energy requirements at 30 days for the intervention group compared to the control group (93% vs 47%, p = 0.01). No other differences were found between the groups.

Conclusion: The individual nutritional intervention did not prevent readmission among geriatric patients in this trial. Recruitment procedures functioned well, and the intervention was well accepted by the patients.

Trial registration: ClinicalTrial.gov, NCT03519139 . Retrospectively registered on 8 May 2018.

Keywords: Home visits after discharge; Nutritional Counseling; Readmission.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Consort diagram showing the enrollment of patients and numbers of patients included in the analysis for readmission and secondary outcome at 30 days. Two patients in the control group stopped in the trial before 30 days but gave permission for the collection of data regarding readmission
Fig. 2
Fig. 2
The intervention group’s compliance to achieving a least 75% of energy and protein requirements at baseline, 1st and 2nd home visits, and 30 and 60 days follow-up

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