title: The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving Home Care: A randomized controlled trial.
abstract: OBJECTIVE
  To assess the effect of a nutrition education intervention included in the Home Care Program for caregivers to prevent the increasing risk of malnutrition of dependent patients at risk of malnutrition.
  
  
  METHODS
  Randomized controlled multicenter trial of 6 months of duration and 12 months follow-up.
  
  
  METHODS
  10 Primary Care Centers, Spain.
  
  
  METHODS
  Patients enrolled in the Home Care Program between January 2010 and March 2012, who were dependent and at risk of malnutrition, older than 65, and had caregivers (n=190).
  
  
  METHODS
  The nurses conducted initial educational intervention sessions for caregivers and then monitored at home every month for 6 months.
  
  
  METHODS
  The nutritional status was assessed using the Mini Nutritional Assessment test (primary outcome), diet, anthropometry, and biochemical parameters (albumin, prealbumin, hemoglobin and cholesterol). Other descriptive and outcome measures were recorded: current medical history, Activities of daily living (Barthel test), cognitive state (Pfeiffer test), and mood status (Yesavage test). All the measures were recorded in a schedule of 0-6-12 months.
  
  
  RESULTS
  173 individuals participated after exclusions (intervention n=101; control n=72). Mean age was 87.8±8.9years, 68.2% were women. Difference were found between the groups for Mini Nutritional Assessment test score change (repeated measures ANOVA, F=10.1; P<0.001), the intervention improved the Mini Nutritional Assessment test score of the participants in the intervention group. The egg consumption (F=4.1; P=0.018), protein intake (F=3.0; P=0.050), polyunsaturated fatty acid intake (F=5.3; P=0.006), folate (F=3.3; P=0.041) and vitamin E (F=6.4; P=0.002) showed significant group×time interactions.
  
  
  CONCLUSIONS
  A nutrition education intervention for caregivers halted the tendency of nutritional decline, and reduced the risk of malnutrition of older dependent patients.
  
  
  BACKGROUND
  Clinical Trial Registration-URL: www.clinicaltrials.gov. Identifier: NCT01360775.
authors.affiliation: Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), c/Sant Llorenç, 21, 43201 Reus, Tarragona, Spain.
authors.forename: Sílvia
authors.initials: S
authors.lastname: Fernández-Barrés
authors.affiliation: Primary Care Department, Camp de Tarragona, Catalan Health Institute, Recinte Joan XXIII, 43001 Tarragona, Spain.
authors.forename: Montse
authors.initials: M
authors.lastname: García-Barco
authors.affiliation: Primary Care Department, Camp de Tarragona, Catalan Health Institute, Recinte Joan XXIII, 43001 Tarragona, Spain; Research Unit Tarragona Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Gran via Corts Catalanes, 57, 08007 Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Basora
authors.affiliation: Primary Care Department, Camp de Tarragona, Catalan Health Institute, Recinte Joan XXIII, 43001 Tarragona, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Martínez
authors.affiliation: Primary Care Department, Camp de Tarragona, Catalan Health Institute, Recinte Joan XXIII, 43001 Tarragona, Spain.
authors.forename: Roser
authors.initials: R
authors.lastname: Pedret
authors.affiliation: Departament de Ciències Mèdiques Bàsiques, Nutrition and Mental Health Research Group (NUTRISAM), Facultat de Medicina i Ciències de la Salut (FMCS), Universitat Rovira i Virgili (URV), c/Sant Llorenç, 21, 43201 Reus, Tarragona, Spain; Research Unit Tarragona Reus, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Gran via Corts Catalanes, 57, 08007 Barcelona, Spain; Pere Virgili Institute (IISPV), Avda. De la Universitat, 1-2a planta, 43204 Reus, Tarragona, Spain. Electronic address: victoria.arija@urv.cat.
authors.forename: Victoria
authors.initials: V
authors.lastname: Arija
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004046:Dietetics / Q000193:education*; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D012307:Risk Factors; D013030:Spain
keywords: Activities of Daily Living; Aged; Caregivers; Home Care; Malnutrition; Nutrition education; Primary Health Care