title: Twenty-five years of home parenteral nutrition outsourcing: the experience at Hospital Universitario La Paz, Madrid.
abstract: BACKGROUND
  For the last 20 years, most adult patients following home parenteral nutrition (HPN) under the care of the Clinical Nutrition and Dietetics Dept. of the La Paz University Hospital (Unidad de Nutrición Clínica y Dietética del Hospital Universitario La Paz), Madrid, Spain, have received their nutrition formula via a catering system (Nutriservice) responsible for its preparation and home distribution.
  
  
  OBJECTIVE
  To assess the clinical characteristics, quality of life and degree of satisfaction with the care received, of patients undergoing HPN who received their nutrition formulae via the named catering service.
  
  
  METHODS
  The characteristics of the patients who received HPN via this service between 1992 and 2013 were retrospectively collected. Those patients still undergoing treatment completed a quality of life questionnaire, plus a survey of their satisfaction with the catering system and the care provided by our department.
  
  
  RESULTS
  Seventy eight patients were examined; 57.7% were men. The mean age of the patients was 53.1±14.3 years. The most common underlying disease was cancer, both in advanced stage (33.8% of all cases) and in stages in which active treatment was being provided (34%). The most common indication for HPN was intestinal obstruction (46%). The median duration of HPN treatment was 96 [1-5334] days. The most common complication was catheter infection (72%). For the analysis of the results, the patients were divided depending on disease type: those with advanced stage cancer, those with cancer under active treatment and with a better prognosis, and those with non-oncological disease. The patients undergoing active oncological treatment believed the quality of their lives to have been improved by the Nutriservice catering system, and rated the care received by our department positively.
  
  
  CONCLUSIONS
  In our experience, patients with cancer are those who most commonly receive HPN, especially those with advanced disease. Given the seriousness of their conditions, and the complexity surrounding the use of HPN, catering systems appear to offer a means of improving their quality of life.
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gómez-Candela
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: María
authors.initials: M
authors.lastname: Martín Fuentes
authors.affiliation: Servicio de Farmacia, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: Natalia
authors.initials: N
authors.lastname: García Vázquez
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: Marta
authors.initials: M
authors.lastname: Crespo Yanguas
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: Arturo
authors.initials: A
authors.lastname: Lisbona Catalán
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: Rocío
authors.initials: R
authors.lastname: Campos Del Portillo
authors.affiliation: Unidad de Nutrición Clínica y Dietética, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.. carmengomezcandela@telefonica.net.
authors.forename: Samara
authors.initials: S
authors.lastname: Palma Milla
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D020416:Outsourced Services / Q000706:statistics & numerical data; D016331:Parenteral Nutrition, Home / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D013030:Spain