Hospital to home outreach for malnourished elders (HHOME) : a feasibility pilot

Mudge, Alison M., Young, Adrienne M., Ross, Lynda J., Isenring, Elisabeth A., Scott, Rosalie A., Scott, Amy N., Daniels, Lynne, & Banks, Merrilyn D. (2012) Hospital to home outreach for malnourished elders (HHOME) : a feasibility pilot. Journal of Aging Research and Clinical Practice, 1(2), pp. 131-134.

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Objectives: Malnutrition is common in older hospitalised patients, and barriers to adequate intake in hospital limit the effectiveness of hospital-based nutrition interventions. This pilot study was undertaken to determine whether nutrition-focussed care at discharge and in the early post-hospital period is feasible and acceptable to patients and carers, and improves nutritional status.

Design: Prospective cohort study

Setting: Internal medicine wards of a tertiary teaching hospital in Brisbane, Australia

Participants: Patients aged 65 and older admitted for at least 3 days, identified as malnourished or at risk of malnutrition using Mini Nutritional Assessment (MNA).

Interventions: An interdisciplinary discharge team (specialist discharge planning nurse and accredited practicing dietitian) provided nutrition-focussed education, advice, service coordination and follow-up (home visits and telephone) for 6 weeks following hospitalisation

Measurements: Nutritional intake, weight, functional status and MNA were recorded 6 and 12 weeks after discharge. Service intensity and changes to care were noted, and hospital readmissions recorded. Service feedback from patients and carers was sought using a brief questionnaire.

Results: 12 participants were enrolled during the 6 week pilot (mean age 82 years, 50% male). All received 1-2 home visits, and 3-8 telephone calls. Four participants had new community services arranged, 4 were commenced on oral nutritional supplements, and 7 were referred to community dietetics services for follow-up. Two participants had a decline in MNA score of more than 10% at 12 week follow-up, while the remainder improved by at least 10%. Individualised care including community service coordination was valued by participants.

Conclusion: The proposed model of care for older adults was feasible, acceptable to patients and carers, and associated with improved nutritional status at 12 weeks for most participants. The pilot data will be useful for design of intervention trials.

Impact and interest:

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ID Code: 52639
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Aged Care Nursing (111001)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NUTRITION AND DIETETICS (111100)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 2012 International Association of Gerontology and Geriatrics
Deposited On: 06 Aug 2012 23:20
Last Modified: 13 Nov 2013 10:45

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