This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Miller, M. D. Articles by Crotty, M. Search for Related Content PubMed PubMed Citation Articles by Miller, M. D. Articles by Crotty, M. Social Bookmarking                   What's this?

Adherence to Nutrition Supplements Among Patients With a Fall-Related Lower Limb Fracture

Michelle D. Miller, MNutrDiet^*, Lynne A. Daniels, PhD, Elaine Bannerman, PhD and Maria Crotty, FAFRM(RACP)^*

^* Department of Rehabilitation and Aged Care and Department of Nutrition and Dietetics, Flinders University, Bedford Park, South Australia, Australia

Correspondence: Maria Crotty, FAFRM(RACP), Flinders University Department of Rehabilitation and Aged Care, C-Block, Repatriation General Hospital, Daws Road, Daw Park, South Australia 5041. Electronic mail may be sent to maria.crotty{at}flinders.edu.au.

Background: The purpose of this study was to provide a detailed evaluation of adherence to nutrition supplements by patients with a lower limb fracture. Methods: These descriptive data are from 49 nutritionally "at-risk" patients aged 70+ years admitted to the hospital after a fall-related lower limb fracture and allocated to receive supplementation as part of a randomized, controlled trial. Supplementation commenced on day 7 and continued for 42 days. Prescribed volumes aimed to meet 45% of individually estimated theoretical energy requirements to meet the shortfall between literature estimates of energy intake and requirements. The supplement was administered by nursing staff on medication rounds in the acute or residential care settings and supervised through thrice-weekly home visits postdischarge. Results: Median daily percent of the prescribed volume of nutrition supplement consumed averaged over the 42 days was 67% (interquartile range [IQR], 31–89, n = 49). There was no difference in adherence for gender, accommodation, cognition, or whether the supplement was self-administered or supervised. Twenty-three participants took some supplement every day, and a further 12 missed <5 days. For these 35 "nonrefusers," adherence was 82% (IQR, 65–93), and they lost on average 0.7% (SD, 4.0%) of baseline weight over the 6 weeks of supplementation compared with a loss of 5.5% (SD, 5.4%) in the "refusers" (n = 14, 29%), p = .003. Conclusions: We achieved better volume and energy consumption than previous studies of hip fracture patients but still failed to meet target supplement volumes prescribed to meet 45% of theoretical energy requirements. Clinicians should consider alternative methods of feeding such as a nasogastric tube, particularly in those patients where adherence to oral nutrition supplements is poor and dietary intake alone is insufficient to meet estimated energy requirements.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?