title: Indicators of oral nutritional supplements prescription in nursing home residents: A cross-sectional study.
abstract: Identifying factors associated with oral nutritional supplement (ONS) prescription in nursing homes (NH) may help to treat malnutrition in this very old and vulnerable population.
  
  
  
  The aim of the study was to investigate if resident-related and NH-related characteristics were associated with ONS prescription.
  
  
  
  Cross-sectional study using medical and demographic data from 6275 NH residents and data on the structure and organization (e.g., presence of a dietitian, organization of the meal) of 175 NHs in southwestern France. The main outcome measure was ONS prescription (dichotomous variable: yes/no).
  
  
  
  ONS were prescribed for 7.8% (n = 489) of NH residents. In a multivariate binary logistic regression, resident-related factors associated with the prescription of ONS were age, clinical markers of undernutrition (body mass index and weight loss), disability in activities of daily living, pain, pressure sores, and hospitalization in the last 12 months. NH-related factors associated with ONS prescription were: presence of a dietitian (Odds Ratio (OR): 1.46, 95% Confidence Interval: 1.18-1.88), NH coordinating physician with specific training in geriatrics (OR: 2.58, 95% CI: 1.48-4.49), organization of evening snack (OR: 1.63, 95% CI: 1.28-2.07), number of general practitioners per NH bed (OR: 0.49, 95% CI: 0.38-0.64 intermediate tertile; OR:0.77, 95% CI:0.59-1.06 highest tertile. Reference category: lowest tertile) and number of drug prescriptions (OR: 0.97, 95% CI: 0.94-0.99).
  
  
  
  Both resident's characteristics and NH characteristics were associated with ONS prescription independently of each other. Our results showed that NH organizational aspects are associated with ONS prescribing, suggesting that modifiable aspects may contribute to achieve optimal nutritional status in the NH setting.
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, F-31059, France; INSERM U1027, University of Toulouse III, Toulouse, France. Electronic address: dupuy.c@chu-toulouse.fr.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Dupuy
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, F-31059, France; INSERM U1027, University of Toulouse III, Toulouse, France.
authors.forename: Philipe
authors.initials: P
authors.lastname: de Souto Barreto
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, F-31059, France; INSERM U1027, University of Toulouse III, Toulouse, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Ghisolfi
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, F-31059, France; INSERM U1027, University of Toulouse III, Toulouse, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Guyonnet
authors.affiliation: Nutricia Advanced Medical Nutrition, Danone Research, Saint-Ouen, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Dorigny
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, F-31059, France; INSERM U1027, University of Toulouse III, Toulouse, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.affiliation: Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, F-31059, France; INSERM U1027, University of Toulouse III, Toulouse, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Rolland
mesh_terms: D000203:Activities of Daily Living; D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D011307:Drug Prescriptions; D005260:Female; D005602:France; D006707:Homes for the Aged; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000188:drug therapy*; D062407:Meals; D015999:Multivariate Analysis; D009735:Nursing Homes; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Elderly; Institutionalization; Malnutrition; Nursing home; Oral nutritional supplement; Undernutrition