Physicians' Perception of Oral Nutritional Supplement Acceptance and Tolerability in Malnourished Outpatients: PerceptiONS Study

P B Pedrianes-Martin, C Dassen-de-Monzo, J M Guardia-Baena, M Riestra-Fernández, C Salom-Vendrell, PerceptiONS Group, A Calvo-Barbero, L Lizán-Tudela, P B Pedrianes-Martin, C Dassen-de-Monzo, J M Guardia-Baena, M Riestra-Fernández, C Salom-Vendrell, PerceptiONS Group, A Calvo-Barbero, L Lizán-Tudela

Abstract

Malnutrition is a common condition associated with various pathologies such as infections, neoplasms and digestive system disorders. Patients can be managed using different strategies, which include dietary modifications or oral nutritional supplements (ONS). It is important to promote good ONS adherence in order to attain clinical efficacy and cost-effectiveness. Several factors (amount, type, duration and tolerability) may have an impact on ONS adherence. PerceptiONS is a descriptive, cross-sectional observational study based on an ad hoc electronic survey designed to explore physicians' perception of malnourished outpatients prescribed ONS. The survey considered adherence, acceptance/satisfaction, tolerability and benefits within the context of Spain's healthcare system. The perceptions of 548 physicians regarding the experience of 2516 patients were analyzed. From the physicians' perspective, 57.11% of patients adhered to over 75% of the prescribed ONS. The organoleptic properties of ONS represented the aspect with the most positive impact on adherence, with smell (43.72%) ranking as the top characteristic. In general, patients were satisfied (90.10%) with the ONS, with their related benefits (88.51%) and their organoleptic properties (90.42%), and accepted ONS in their daily diet (88.63%). ONS improved patients' general condition (87.04%), quality of life (QoL) (81.96%) and vitality/energy (81.28%). Physicians would prescribe the same ONS again in 96.4% of the cases.

Keywords: acceptance; adherence; malnourished; malnutrition; non-hospitalized; oral nutritional supplements; outpatients; satisfaction; tolerability.

Conflict of interest statement

Pablo Pedrianes, Carolina Dassen, Juan M. Guardia, María Riestra and Christian Salom declare no conflicts of interest in this work. The funders had no role in the study design; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. María Riestra has received honoraria for consultancy and lectures from Abbott, Nutricia, Persan. Luis Lizán and Ana Calvo state that their employer, Outcomes’10, has received fees from Abbott Laboratories, S.A for contributing to the study design, the collection, analyses or interpretation of data and the project coordination, as well as the drafting of this manuscript.

Figures

Figure 1
Figure 1
The tool employed to evaluate patient malnutrition by endocrinologists and nutritionists vs. the rest of the specialists (digestive, geriatrics, hematology, internal medicine, medical oncology, radiation oncology and others).
Figure 2
Figure 2
(A) Which of these organoleptic properties: smell, flavor or texture, has the most influence on adherence to the nutritional supplement? (B) Which of these options: organoleptic properties, the number of daily intakes prescribed or the consumption of the supplement maintained over time, has influenced ONS adherence most positively?
Figure 2
Figure 2
(A) Which of these organoleptic properties: smell, flavor or texture, has the most influence on adherence to the nutritional supplement? (B) Which of these options: organoleptic properties, the number of daily intakes prescribed or the consumption of the supplement maintained over time, has influenced ONS adherence most positively?
Figure 3
Figure 3
(A) Overall patient satisfaction with the ONS received; (B) Level of satisfaction with the benefit of the ONS; (C) Patient satisfaction with the organoleptic properties.
Figure 3
Figure 3
(A) Overall patient satisfaction with the ONS received; (B) Level of satisfaction with the benefit of the ONS; (C) Patient satisfaction with the organoleptic properties.
Figure 4
Figure 4
(A) Influence of organoleptic properties on patient satisfaction; (B) Degree of acceptance of the patient’s ONS in their daily diet.
Figure 5
Figure 5
Improvement in the patients’ general condition, vitality/energy and QoL by ONS.
Figure 6
Figure 6
Improvement in the patients’ symptoms (diarrhea, nausea, vomiting, abdominal pain, bloating) by ONS (N = 638 physicians).
Figure 7
Figure 7
Improvement in the patients’ physical condition by ONS (N = 863 physicians).
Figure 8
Figure 8
Improvement in the patients’ glycemic control by ONS (N = 749 physicians).

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