title: A Pre-post Evaluation of an Ambulatory Nutrition Support Service for Malnourished Patients Post Hospital Discharge: A Pilot Study.
abstract: BACKGROUND
  Malnutrition is common among hospitalised patients, with poor follow up of nutrition support post-discharge. Published studies on the efficacy of ambulatory nutrition support (ANS) for malnourished patients post-discharge are scarce. The aims of this study were to evaluate the rate of dietetics follow-up of malnourished patients postdischarge, before (2008) and after (2010) implementation of a new ANS service, and to evaluate nutritional outcomes post-implementation.
  
  
  METHODS
  Consecutive samples of 261 (2008) and 163 (2010) adult inpatients referred to dietetics and assessed as malnourished using Subjective Global Assessment (SGA) were enrolled. All subjects received inpatient nutrition intervention and dietetic outpatient clinic follow-up appointments. For the 2010 cohort, ANS was initiated to provide telephone follow-up and home visits for patients who failed to attend the outpatient clinic. Subjective Global Assessment, body weight, quality of life (EQ-5D VAS) and handgrip strength were measured at baseline and five months post-discharge. Paired t-test was used to compare pre- and post-intervention results.
  
  
  RESULTS
  In 2008, only 15% of patients returned for follow-up with a dietitian within four months post-discharge. After implementation of ANS in 2010, the follow-up rate was 100%. Mean weight improved from 44.0 ± 8.5 kg to 46.3 ± 9.6 kg, EQ-5D VAS from 61.2 ± 19.8 to 71.6 ± 17.4 and handgrip strength from 15.1 ± 7.1 kg force to 17.5 ± 8.5 kg force; P <0.001 for all. Seventy-four percent of patients improved in SGA score.
  
  
  CONCLUSIONS
  Ambulatory nutrition support resulted in significant improvements in followup rate, nutritional status and quality of life of malnourished patients post-discharge.
authors.affiliation: Dietetics Department, National University Hospital, Singapore. Su_Lin_Lim@nuhs.edu.sg
authors.forename: Su Lin
authors.initials: SL
authors.lastname: Lim
authors.forename: Xianghui
authors.initials: X
authors.lastname: Lin
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Maree
authors.initials: M
authors.lastname: Ferguson
authors.forename: Lynne
authors.initials: L
authors.lastname: Daniels
mesh_terms: D001835:Body Weight; D018737:Hand Strength; D006801:Humans; D009752:Nutritional Status; D010865:Pilot Projects; D011788:Quality of Life