Compliance of energy-dense, small volume oral nutritional supplements in the daily clinical practice on a geriatric ward — An observational study

• Published in: The Journal of nutrition, health & aging health & aging, 2014-07, Vol.18 (7), p.649-653
• Main Authors: Lombard, Karien, van Steijn, J, Schuur, T, Kuhn, M, Rouws, C, Huinink, E.-L, van der Hooft, C, van Asselt, D
• Format: Article
• Language: English
• Subjects: Administration, Oral; Aged; Biological and medical sciences; Body Mass Index; bottles; clinical trials; compliance; Dietary Supplements; energy; Energy Intake; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Geriatric Assessment - methods; Humans; Inpatients; Male; Malnutrition - drug therapy; Micronutrients - administration & dosage; nutrition risk assessment; observational studies; Patient Compliance; patients; statistical models; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-014-0490-8

INTRODUCTION: Compliance is important in optimizing the clinical effectiveness of oral nutritional supplements (ONS). Small volume, energy-dense ONS (ED-ONS; ≥2 kcal/ml) have been shown to improve compliance in clinical trial settings. However, data from clinical practice is still lacking. The aim of the present study was to evaluate the effect of ED-ONS on the compliance in an observational set-up to obtain data from daily clinical practice on a geriatric ward. METHODS: Geriatric inpatients, undernourished or at risk of undernutrition received two servings of either ED-ONS (125ml, 2.4 kcal/ml: Nutridrink Compact Energy, Nutricia) or a standard ONS (S-ONS; 200ml, 1.5 kcal/ml: Nutridrink) as part of their daily routine care. Patients were allocated to a group according to availability of beds and placement on the ward. Compliance (kcal/day and % of prescribed volume) was assessed by weighing returned bottles. Data were analyzed via Mixed Model for Repeated Measures. RESULTS: Forty-seven patients received ED-ONS, and 61 patients received S-ONS. Compliance was significantly higher with ED-ONS in geriatric inpatients compared to S-ONS ( 378 ± 14.0 kcal/day vs. 337 ± 13.6 kcal/day (mean±SEM), p = 0.039, 63.0 ± 2.34% vs. 56.2 ± 2.26%, p = 0.039). Moreover, a trend (p=0.078) was observed towards an increasing difference in compliance over time. CONCLUSION: This study shows that compliance to ED-ONS is significantly better than to S-ONS in daily clinical practice. Although small, the difference in compliance seems to increase over time, suggesting clinical relevance with longer treatment.