Integrated nutritional intervention in the elderly after hip fracture. A process evaluation.
OBJECTIVE
Within a multicentre randomized controlled trial aimed at improving the nutritional status and increase the speed of recovery of elderly hip fracture patients, we performed a process evaluation to investigate the feasibility of the intervention within the present Dutch health care system.


METHODS
Patients in the intervention group received nutritional counseling during 10 contacts. Oral nutritional supplements were advised as needed until three months after hip fracture surgery. The intervention was evaluated with respect to dieticians' adherence to the study protocol, content of nutritional counseling, and patients' adherence to recommendations given.


RESULTS
We included 66 patients (mean age of 76, range 55-92 years); 74% women. Eighty-three percent of patients received all 10 contacts as planned, but in 62% of the patients one or more telephone calls had to be replaced by face to face contacts. Nutritional counseling was complete in 91% of contacts. Oral nutritional supplementation was needed for a median period of 76 days; 75% of the patients took the oral nutritional supplements as recommended.


CONCLUSIONS
Nutritional counseling in elderly hip fracture patients through face to face contacts and telephone calls is feasible. However, individual tailoring of the intervention is recommended. The majority of hip fracture patients needed >2 months oral nutritional supplements to meet their nutritional requirements. The trial was registered at clincialtrails.gov as NCT00523575.
Department of Epidemiology, School for Public Health and Primary Care - CAPHRI, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands. jose.breedveld@maastrichtuniversity.nl
José J L
JJ
Breedveld-Peters
Petronella L M
PL
Reijven
Caroline E
CE
Wyers
Svenhjalmar
S
van Helden
J J Chris
JJ
Arts
Berry
B
Meesters
Martin H
MH
Prins
Trudy
T
van der Weijden
Pieter C
PC
Dagnelie
D000368:Aged; D000369:Aged, 80 and over; D004044:Dietary Proteins / Q000008:administration & dosage*; D019587:Dietary Supplements; D002149:Energy Intake; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006620:Hip Fractures / Q000178:diet therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009751:Nutritional Requirements; D009752:Nutritional Status; D010349:Patient Compliance; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D011795:Surveys and Questionnaires
D004044:Dietary Proteins