Oral nutritional interventions in frail older people who are malnourished or at risk of malnutrition: a systematic review

Malnutrition worsens the health of frail older adults. Current treatments for malnutrition may include prescribed oral nutritional supplements, which are multinutrient products containing macronutrients and micronutrients. To assess the effectiveness and cost-effectiveness of oral nutritional supple...

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Bibliographic Details
Published in:Health technology assessment (Winchester, England) England), 2022-12, Vol.26 (51), p.1-112
Main Authors: Thomson, Katie, Rice, Stephen, Arisa, Oluwatomi, Johnson, Eugenie, Tanner, Louise, Marshall, Christopher, Sotire, Tumi, Richmond, Catherine, O'Keefe, Hannah, Mohammed, Wael, Gosney, Margot, Raffle, Anne, Hanratty, Barbara, McEvoy, Claire T, Craig, Dawn, Ramsay, Sheena E
Format: Article
Language:English
Subjects:
Aged
Body Weight
Cost-Benefit Analysis
dietary supplements
Frail Elderly
frailty
Humans
malnutrition
Malnutrition - therapy
Quality of Life
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Summary:Malnutrition worsens the health of frail older adults. Current treatments for malnutrition may include prescribed oral nutritional supplements, which are multinutrient products containing macronutrients and micronutrients. To assess the effectiveness and cost-effectiveness of oral nutritional supplements (with or without other dietary interventions) in frail older people who are malnourished or at risk of malnutrition. MEDLINE, EMBASE, Cochrane Library, Scopus, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and grey literature were searched from inception to 13 September 2021. A systematic review and meta-analysis was conducted to evaluate the effectiveness and cost-effectiveness of oral nutritional supplements in frail older people (aged ≥ 65 years) who are malnourished or at risk of malnutrition (defined as undernutrition as per National Institute for Health and Care Excellence guidelines). Meta-analysis and network meta-analysis were undertaken, where feasible, along with a narrative synthesis. A cost-effectiveness review was reported narratively. A de novo model was developed using effectiveness evidence identified in the systematic review to estimate the cost-effectiveness of oral nutritional supplements. Eleven studies (  = 822 participants) were included in the effectiveness review, six of which were fully or partly funded by industry. Meta-analyses suggested positive effects of oral nutritional supplements compared with standard care for energy intake (kcal) (standardised mean difference 1.02, 95% confidence interval 0.15 to 1.88; very low quality evidence) and poor mobility (mean difference 0.03,  
ISSN:1366-5278
2046-4924
DOI:10.3310/CCQF1608