Beck AM, Kjær S, Hansen BS, Storm RL, Thal-Jantzen K, Bitz C. EFFECT, The Nordic Kitchen, Herlev University Hospital, Herlev, Denmark. Clin Rehabil. 2013 Jun;27(6):483-93. doi: 10.1177/0269215512469384. Epub 2012 Dec 20.
Objective: To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients’ home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality. Design: Twelve-week single-blind randomized controlled study.
Setting and subjects: Geriatric medical patients (65+ years) at nutritional risk. Interventions: Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented with three follow-up visits by general practitioners or three follow-up visits by general practitioners alone. Main measures: Primary outcome was risk of re-admissions. Secondary outcomes were functional status (hand grip strength, chair stand, mobility, disability and tiredness in daily activities, rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality.
Results: One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks. Ten per cent of the participants had three contacts with their general practitioner, while compliance with the dietetic intervention was almost 100%. Odds ratio for re-admission and mortality after 26 weeks was 1.62 (95% confidence interval (CI) 0.85 to 3.10) and 0.60 (95% CI 0.17 to 2.13). The intervention had a positive effect on functional status (i.e. mobility, P = 0.029), and nutritional status (i.e. weight, P = 0.035; energy intake, P < 0.001; protein intake, P = 0.001) and the use of meals-on wheels was reduced (P = 0.084).
Conclusion: Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge.