부산대학교 도서관

Aim: Nutritional decline during and after acute hospitalisation is common amongst older people. This quality improvement initiative aimed to introduce a dietitian‐led discharge planning and follow‐up program (Hospital to Home Outreach for Malnourished Elders, HHOME) at two hospitals within usual resources to improve nutritional and functional recovery. Methods: Prospective pre–post evaluation design was used. Medical patients aged 65+ years at‐risk of malnutrition and discharged to independent living were eligible. Participants receiving nutrition discharge planning and dietetic telephone follow up for four weeks post‐discharge (‘HHOME’) were compared to usual care (‘pre‐HHOME’). Nutritional (weight and mini nutritional assessment (MNA)), functional (gait speed, handgrip strength and modified Barthel index) and assessment of quality of life‐6D (AQoL‐6D) outcomes were measured on discharge and six weeks later. Results: At six weeks, no significant difference in nutritional status was observed between pre‐HHOME (n = 39) and HHOME cohorts, although the HHOME cohort on average maintained weight while pre‐HHOME cohort lost weight (0.4 ± 2.9 kg vs −1.0 ± 3.7 kg, P = 0.060). Greater improvement in gait speed was seen in HHOME group (+0.24 ± 0.27 vs +0.11 ± 0.22, P = 0.046) with no other significant outcome improvements. Across both cohorts, half were readmitted to hospital and 10% died within 12 weeks post‐discharge. Conclusions: The nutritional discharge planning and dietetic follow up provided to older community‐living malnourished patients made a small impact on nutritional and functional parameters but clinical outcomes remained poor. [ABSTRACT FROM AUTHOR]