[Update of enteral nutrition at the patient's home].
Home enteral nutrition is the administration of enteral formulae into the digestive tract using a tube, with the objective of preventing or correcting malnutrition patients who are seen at home. Home enteral nutrition is a type of nutritional support that is growing, that improves the nutritional status of the patient with a lower cost and with a greater quality of life of the family unit than enteral nutrition in the hospital. The prevalence is clearly increasing although the data of the national registers of patients with at home enteral nutrition are under estimated. Patients who are candidates for home enteral nutrition can be all those with an indication for enteral nutrition and whose underlying disease is stabilized or does not require all the technical means of the hospital in a permanent and essential manner. Neoplasias and neurological diseases are those that benefit most from at home enteral nutrition and in all registries each group varies between 30 and 40%. All access routes and all enteral nutrition formulae can be used in patients with home enteral nutrition. The use of percutaneous endoscopic gastrostomies is ever more recommended in patients who need at home enteral nutrition for a period longer than 4 weeks. Since the publication of the Ministerial Order of June 2nd 1998, home enteral nutrition is considered a health care service that can be covered by the Social Security. This order lists a series of disease that are likely to be treated with at home enteral nutrition (in our opinion the list is not complete but it is likely to be changed in the future by an Assessing Committee), and it presents some basic norms that all patients must comply with, regardless of the autonomous community in which they live. Before beginning at home enteral nutrition the training of the patient and/or the family with regard to the management of at home enteral nutrition is essential. The existence of qualified personnel with experience in this nutritional support technique, as well as the collaboration between Primary Care and Specialized Care (Clinical Nutrition Units if these exist in the health care area) is essential for the control and follow up of the patient with at home enteral nutrition.
García-Luna
P P
PP
Unidad de Nutrición Clínica y Dietética, Hospital Universitario Virgen del Rocío, Sevilla, España.
Parejo Campos
J
J
Fenoy Macías
J L
JL
D004750:Enteral Nutrition / Q000379:methods*; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D009369:Neoplasms / Q000628:therapy; D009422:Nervous System Diseases / Q000628:therapy; D009751:Nutritional Requirements; D017060:Patient Satisfaction; D013030:Spain; D013997:Time Factors