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Study Protocol: Nutritional Support in a Cross-sector Model for the Rehabilitation of Geriatric Patients: A Randomized Controlled Trial

Beck A, Rask KØ, Leedo E, Jensen LL, Martins K and Vedelspang A

Background: Hospital stays are generally getting shorter which leaves limited time to improve a poor nutritional status for geriatric patients. Therefore, it seems necessary to integrate nutritional support also in the period after discharge. Furthermore, improving cross-sector cooperation in the transition of geriatric patients between hospital and home-care institutions is essential to ensure follow-up and completion of hospital (nutritional) treatment and rehabilitation of patients. In spite of many issues, i.e. the multi-morbidity, the reduced level of functioning and the excessive use of medication, which have a negative impact of appetite and food intake, little research, has been done to address these problems by investigating the effect of a more comprehensive systematic nutritional approach.
Method: A twelve-week randomised controlled trial comparing discharge standard Follow-home Team vs. discharge Follow-home Team in cooperation with a Registered Dietician. Patients are eligible for this study when they are 70+ years old and at nutritional risk. The registered Dietician will perform three home visits. The first visit will take place at the day of discharge together with the Follow-home Team, while the remaining visits will take place approximately three and eight weeks after discharge and will be performed by the RD alone. The information gathered by the Follow-home Team i.e. regarding the
medical treatment, the patient’s functional abilities and ability to cope with activities of daily living, and the need for change in social services, will be taken into consideration. The primary outcome parameter will be muscle strength measured as handgrip strength. Secondary outcomes will be nutritional status, dietary intake, physical performance, mobility, Activities of Daily Living, quality of life, use of social services, re-admissions and mortality.
Discussion: This project is the first to combine individualized nutritional intervention with intervention from an established Follow-home Team. The results will hopefully help to ensure the cross-sector quality of nutritional support to geriatric patients. This may ultimately lead to reduced health care costs, and improvement in mobility, independence and quality of life for geriatric patients at nutritional risk.
Trial registration: Clinical Trials.gov NCT01776762.