A personalized snack-based intervention for hip fracture patients: development, feasibility and acceptability.
BACKGROUND
Undernutrition is common in older people admitted to hospital with hip fracture. Oral supplementation with sip feeds may be provided but compliance is a major problem.


OBJECTIVE
To develop a personalized snack-based intervention for practical implementation in hip fracture patients and to assess feasibility, adherence, acceptability and cost.


METHODS
Twenty-three older hip fracture patients with a mean age (SD) 84.1 (6.3) were provided with three between-meal snacks daily for 4 weeks following surgery. Dietary counselling, assessment of acceptability and feasibility were undertaken and costs of intervention calculated.


RESULTS
Sixteen of the 23 participants recruited completed the study. Mean estimated energy derived from the snacks provided 26% of daily energy requirements. Monitoring adherence proved problematic and stocktakes highlighted discrepancies. Although several participants reported that they did not usually eat between meals, overall the intervention was acceptable to participants. The cost of implementation was 21.29 UK pounds per participant per week.


CONCLUSIONS
Although it proved feasible, practical difficulties were encountered with implementation and adherence due to timing. A more appropriate time to deliver such an intervention may be after the acute phase is over and patients are back home. The costs compared favourably with the alternative of providing sip feeds.
Section of Ageing and Health, Division of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK. r.j.g.price@dundee.ac.uk
Rosemary J G
RJ
Price
Marion E T
ME
McMurdo
Annie S
AS
Anderson
D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D005526:Food, Formulated; D006620:Hip Fractures / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000150:complications / Q000628:therapy*; D009751:Nutritional Requirements; D009752:Nutritional Status; D010349:Patient Compliance; D016896:Treatment Outcome