Does additional feeding support provided by health care assistants improve nutritional status and outcome in acutely ill older in-patients?--a randomised control trial.
OBJECTIVE
Malnutrition is common in the elderly and increases morbidity and mortality. Most attempts to reverse malnutrition have used liquid supplements, but the findings are inconsistent. This study tests a new approach using a randomised-controlled design. The aim was to examine whether health care assistants, trained to provide additional support with feeding, can improve acutely ill elderly in-patients' clinical outcomes.


METHODS
The study was carried out on three acute medicine for the elderly wards at Hammersmith Hospitals NHS Trust, London. In all, 592 patients, all over 65 years old, were recruited.


RESULTS
The results showed that the median time patients received feeding support was 16 days, and the assisted group was given less intravenous antibiotics (P=0.007). However, the groups did not differ in markers of nutritional status, Barthel score, grip strength, length of stay or mortality.


CONCLUSIONS
It was concluded that the use of health care assistants in this specialised role, in an acute setting, without change to the food provision or without targeting higher risk patients, reduced the need for intravenous antibiotics. However, the intervention did not improve nutritional status or have an effect on length of stay in the time span studied. The results highlight the difficulties of improving the intake of acutely ill elderly patients during a hospital stay.
Hickson
Mary
M
Department of Nutrition and Dietetics, Hammersmith Hospitals NHS Trust, Du Cane Road, London W12 0HS, UK.
Bulpitt
Christopher
C
Nunes
Maria
M
Peters
Ruth
R
Cooke
Jonathon
J
Nicholl
Claire
C
Frost
Gary
G
D000208:Acute Disease / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*; D009752:Nutritional Status; D018529:Nutritional Support; D011502:Protein-Energy Malnutrition / Q000401:mortality / Q000517:prevention & control / Q000628:therapy; D016896:Treatment Outcome