PRESCRIPTION AND INDICATION OF ORAL NUTRITIONAL SUPPLEMENTS IN A SWISS UNIVERSITY HOSPITAL: A QUALITY CONTROL PROSPECTIVE STUDY

Introduction:

Patients with an acute or chronically negative nutritional balance are at nutritional risk. Oral nutritional supplements (ONS) are simple and effective medical treatments of nutritional risk. In our hospital, ONS can be distributed on medical prescription or on personal initiative of the caregivers. In the ambulatory setting, in Switzerland, a NRS-2002≥3 is required for the reimbursement of ONS by the public insurance (LAMal). The reimbursement requires a medical ONS prescription and the ONS delivery at the patient's home by a homecare service.

Objectives:

This survey aimed at documenting: 1) the existence and adequacy of a medical prescription for ONS during hospitalisation and discharge for home, and 2) the persistence or not of ONS treatment one month after discharge for home.

Methods:

Data of this prospective observational survey were collected in adult patients hospitalised in surgery, medicine or rehabilitation and about to receive ONS on their meal trays. Patients already on ONS, those with major consciousness disorders, refusing to consume ONS or to participate to the survey were excluded. ONS prescription and adequacy of ONS indication, assessed by a Nutrition Risk Score-2002 (NRS-2002)≥3, were evaluated at first ONS delivery on the meal tray and at hospital discharge. At home, the persistence of ONS consumption was evaluated by the homecare service one month after discharge. Results are presented as mean ± SD or percentages.

Results:

416 patients (71.7 ± 14.1yrs, 52.6%♂, body mass index 23.6 ± 5.2 kg/m²) were included. At the first delivery of an ONS on the meal tray, 44.5% (n = 185) of patients had no ONS medical prescription, and 82.7% (n = 344) had an NRS-2002 score≥3. Out of 207 patients discharged for home, only 24.2% (n = 50) had an adequate homecare ONS prescription and, 68.1% (n = 141) had a NRS-2002 score≥3. One month after discharge for home, 76.3% (n = 29) were still on ONS.

Conclusion:

During hospitalisation, a medical prescription of ONS is often missing. ONS are mostly given to patients at nutritional risk upon the first ONS delivery. At discharge for home, few patients receive ONS prescription and homecare service. If a medical ONS prescription is performed, ONS are generally continued one month after discharge for home.

Disclosure of Interest:

None declared.