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- Title
Compliance of nursing home residents with a nutrient- and energy-dense oral nutritional supplement determines effects on nutritional status.
- Authors
Jobse, Inken; Liao, Y.; Bartram, M.; Delantonio, K.; Uter, W.; Stehle, P.; Sieber, C.; Volkert, D.
- Abstract
Objectives: Administration of oral nutritional supplements (ONS) is an effective strategy to treat and avoid malnutrition, a persisting issue in nursing homes. However, little is known about compliance in the NH population. This study aimed to analyse the effects of compliance of NH residents with a low-volume, nutrientand energy-dense ONS on nutritional status and to identify residents' characteristics associated with compliance. Design & Setting: Randomized, controlled trial in nursing homes. Participants & Intervention: 87 nursing home residents (87±6y, 91% female) with malnutrition or at risk of malnutrition were randomly allocated to an intervention group (IG) receiving 2×125 ml ONS (2.4 kcal/ml)/d for 12 weeks, or the control group (CG) with usual care. Measurements: ONS intake was recorded daily and compliance calculated. Low and high compliance were defined as ≤30% and ≥80% of provided ONS actually consumed, respectively. Body weight (BW), BMI, upper-arm (UAC) and calf-circumference (CC) and MNA-SF were assessed at baseline and after 12 weeks. Associations between compliance and changes of nutritional parameters and residents' characteristics were analysed. Results: Compliance was high in 35.7% and low in 28.6% of the IG (n=42). BW change was significantly higher in subjects with high compliance (median +3.0 (interquartile range +2.1;+3.8) kg, n=15) than in those with low compliance (−0.2 (−2.2;+1.6) kg, n=12) and CG (−0.1 (−1.2; +0.6) kg, n=35; p<0.001), and significantly correlated with compliance in IG (r=0.691; p<0.001). Significant differences and correlations were also identified for BMI, UAC and MNA-SF. High compliance was more often observed in residents with malnutrition (66.7 vs. 27.3%) and chewing difficulties (77.8 vs. 24.2%) than in those without these conditions. Low compliance was more prevalent in residents who were immobile (45.0 vs. 13.6%), depressed (33.3 vs. 6.7%) or had gastrointestinal complaints (50.0 vs. 17.9%) (all p<0.05). Conclusions: A high compliance of nursing home residents with a low volume, nutrient- and energy dense ONS was related to a significantly improved nutritional status in comparison to low compliance and therefore enhanced the effectiveness of ONS. A higher compliance may be achieved by consideration of different residents' characteristics.
- Subjects
GERMANY; PREVENTION of malnutrition; ANALYSIS of variance; ANTHROPOMETRY; CHI-squared test; DIETARY supplements; DRUGS; DOSE-effect relationship in pharmacology; NURSING home patients; HEALTH outcome assessment; PATIENT compliance; RESEARCH funding; STATISTICAL sampling; STATISTICS; DATA analysis; RANDOMIZED controlled trials; GERIATRIC Depression Scale; DATA analysis software; DESCRIPTIVE statistics; NUTRITIONAL status; KRUSKAL-Wallis Test
- Publication
Journal of Nutrition, Health & Aging, 2015, Vol 19, Issue 3, p356
- ISSN
1279-7707
- Publication type
Article
- DOI
10.1007/s12603-014-0544-y