title: Compliance of energy-dense, small volume oral nutritional supplements in the daily clinical practice on a geriatric ward--an observational study.
abstract: BACKGROUND
  Compliance is important in optimizing the clinical effectiveness of oral nutritional supplements (ONS). Small volume, energy-dense ONS (ED-ONS; ≥ 2 kcal/ml) have been shown to improve compliance in clinical trial settings. However, data from clinical practice is still lacking. The aim of the present study was to evaluate the effect of ED-ONS on the compliance in an observational set-up to obtain data from daily clinical practice on a geriatric ward.
  
  
  METHODS
  Geriatric inpatients, undernourished or at risk of undernutrition received two servings of either ED-ONS (125 ml, 2.4 kcal/ml: Nutridrink Compact Energy, Nutricia) or a standard ONS (S-ONS; 200 ml, 1.5 kcal/ml: Nutridrink) as part of their daily routine care. Patients were allocated to a group according to availability of beds and placement on the ward. Compliance (kcal/day and % of prescribed volume) was assessed by weighing returned bottles. Data were analyzed via Mixed Model for Repeated Measures.
  
  
  RESULTS
  Forty-seven patients received ED-ONS, and 61 patients received S-ONS. Compliance was significantly higher with ED-ONS in geriatric inpatients compared to S-ONS ( 378 ± 14.0 kcal/day vs. 337 ± 13.6 kcal/day (mean ± SEM), p = 0.039, 63.0 ± 2.34% vs. 56.2 ± 2.26%, p = 0.039). Moreover, a trend (p=0.078) was observed towards an increasing difference in compliance over time.
  
  
  CONCLUSIONS
  This study shows that compliance to ED-ONS is significantly better than to S-ONS in daily clinical practice. Although small, the difference in compliance seems to increase over time, suggesting clinical relevance with longer treatment.
authors.affiliation: Karien Lombard, Department of Geriatric Medicine, Medical Centre Leeuwarden, Postbus 888, 8901 BR Leeuwarden, The Netherlands, Phone: +31582863195, Fax: +31582866837, Email address: k.lombard@sze.nl.
authors.forename: K
authors.initials: K
authors.lastname: Lombard
authors.forename: J
authors.initials: J
authors.lastname: van Steijn
authors.forename: T
authors.initials: T
authors.lastname: Schuur
authors.forename: M
authors.initials: M
authors.lastname: Kuhn
authors.forename: C
authors.initials: C
authors.lastname: Rouws
authors.forename: E-L
authors.initials: EL
authors.lastname: Huinink
authors.forename: C
authors.initials: C
authors.lastname: van der Hooft
authors.forename: D
authors.initials: D
authors.lastname: van Asselt
mesh_terms: D000284:Administration, Oral; D000368:Aged; D015992:Body Mass Index; D019587:Dietary Supplements; D002149:Energy Intake; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D007297:Inpatients; D008297:Male; D044342:Malnutrition / Q000188:drug therapy; D018977:Micronutrients / Q000008:administration & dosage*; D010349:Patient Compliance
chemical_list: D018977:Micronutrients