Family MD Toolkit

Malnutrition Toolkit for Family MDs or Primary Care Providers

Malnutrition in adults and especially  older adults is a serious health issue that needs to be addressed. In Canada, it has been reported that 20-45% patients admitted to hospital are malnourished.^1,2,3 After being discharged from hospital, it has been found that one in four adult patients lose weight,⁴ and one in three adults aged >65 years living in the community are at risk for malnutrition.⁵ Nutrition interventions provided in a primary & community setting or post hospital discharge have a positive impact on intake⁶, quality of life⁷, healthcare costs⁸ and even mortality.⁹ Nutrition screening  in a family practice setting can help you support your clients with evidence based interventions and prevent malnutrition.¹⁰

Contents

References

¹Allard JP, Keller H, Jeejeebhoy KN et al. Malnutrition at hospital admission: contributors and impact on length of stay. A prospective cohort study from the Canadian Malnutrition Task Force. J Parenter Enteral Nutr. 2016; 40(4): 487-497. https://pubmed.ncbi.nlm.nih.gov/25623481/

²Keller H, Koechl JM, Laur C et al. More-2-Eat implementation demonstrates that screening, assessment and treatment of malnourished patients can be spread and sustained in acute care; a multi-site, pretest post-test time series study. Clin Nutr. 2021 Apr;40(4):2100-2108. https://pubmed.ncbi.nlm.nih.gov/33077271/

³Keller HH, Valaitis R, Laur CV et al. Multi-site implementation of nutrition screening and diagnosis in medical care units: Success of the More-2-Eat project. Clin Nutr. 2019 Apr;38(2):897-905. https://pubmed.ncbi.nlm.nih.gov/28225049/

⁴Keller H, Laporte M, Payette H et al. Prevalence and predictors of weight change post discharge from hospital: a study of the Canadian Malnutrition Task Force. Eur J Clin Nutr. 2017 Jun;71(6):766-772. https://pubmed.ncbi.nlm.nih.gov/28225049/

⁵Ramage-Morin P, Garriguet D.  Nutritional risk among older Canadians, Statistics Canada, Catalogue no. 82-003-X, Health Reports, 2013;24( 3): 3-13.

⁶Munk T, Bruun N, Nielsen M, Thomsen T. From evidence to clinical practice: positive effect of implementing a protein-enriched hospital menu in conjunction with individualized dietary counseling. Nutr Clin Pract. 2017;32(3):420–6. https://pubmed.ncbi.nlm.nih.gov/28145792/

⁷Rasmussen NML, Belqaid K, Lugnet K et al. Effectiveness of multidisciplinary nutritional support in older hospitalised patients: A systematic review and meta-analyses. Clin Nutr ESPEN. 2018 Oct 1;27:44–52. https://pubmed.ncbi.nlm.nih.gov/30144892/

⁸Howatson A, Wall CR, Turner-Benny P. The contribution of dietitians to the primary health care workforce. J Prim Health Care. 2015 Dec 1;7(4):324-32. https://pubmed.ncbi.nlm.nih.gov/26668838/

⁹Deutz NE, Matheson EM, Matarese LE, et al. Readmission and mortality in malnourished, older, hospitalized adults treated with a specialized oral nutritional supplement: A randomized clinical trial. Clinical Nutrition. 2016;35(1):18-26. https://pubmed.ncbi.nlm.nih.gov/26797412/

¹⁰Hamirudin AH, Charlton K, Walton K, et al. Feasibility of implementing routine nutritional screening for older adults in Australian general practices: a mixed-methods study. BMC Fam Pract. 2014 Nov 25;15:186. https://pubmed.ncbi.nlm.nih.gov/25421546/

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