TY - JOUR
T1 - Optimizing the nutrition support care model
T2 - Analysis of survey data
AU - ASPEN Physician Engagement Committee
AU - Mundi, Manpreet S.
AU - Mechanick, Jeffrey I.
AU - Mohamed Elfadil, Osman
AU - Patel, Jayshil J.
AU - Bonnes, Sara L.
AU - Blackmer, Allison B.
AU - Christian, Vikram J.
AU - Hennessy, Sara A.
AU - Hurt, Ryan T.
AU - Jain, Ajay
AU - Kaspar, Matthew B.
AU - Katz, Jennifer
AU - Labossiere, Reginald
AU - Limketkai, Berkeley N.
AU - McCarthy, Paul J.
AU - Morrison, Chet A.
AU - Newberry, Carolyn
AU - Pimiento, Jose M.
AU - Rosenthal, Martin D.
AU - Taylor, Beth
AU - McClave, Stephen A.
N1 - Publisher Copyright:
© 2022 American Society for Parenteral and Enteral Nutrition.
PY - 2022/9
Y1 - 2022/9
N2 - Background: Malnutrition is underrecognized and underdiagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high-risk patients with malnutrition remains low despite evidence demonstrating lower complication rates with nutrition support team (NST) management. To facilitate solutions, a survey was designed to elucidate the nature of NSTs and physician involvement and identify needs for novel nutrition support care models. Methods: This survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth. Results: Of 255 respondents, 235 complete surveys were analyzed. The geographic distribution of respondents correlated with population concentrations of the United States (r = 90.8%, p <.0001). Most responding physicians (46/57; 80.7%) reported being a member of NSTs, compared with 56.5% (88/156) of dietitians. Of those not practicing in NSTs (N = 81/235, 34.4%), 12.3% (10/81) reported an NST was previously present at their institution but had been disbanded. Regarding NSTs, financial concerns were common (115/235; 48.9%), followed by leadership (72/235; 30.6%), and healthcare professional (HCP) interest (55/235; 23.4%). A majority (173/235; 73.6%) of all respondents wanted additional training in nutrition but reported insufficient protected time, ability to travel, or support from administrators or other HCPs. Conclusion: Core actions resulting from this survey focused on formalizing physician roles, increasing interdisciplinary nutrition support expertise, utilizing cost-effective screening for malnutrition, and implementing intervention protocols. Additional actions included increasing funding for clinical practice, education, and research, all within an expanded portfolio of pragmatic nutrition support care models.
AB - Background: Malnutrition is underrecognized and underdiagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high-risk patients with malnutrition remains low despite evidence demonstrating lower complication rates with nutrition support team (NST) management. To facilitate solutions, a survey was designed to elucidate the nature of NSTs and physician involvement and identify needs for novel nutrition support care models. Methods: This survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth. Results: Of 255 respondents, 235 complete surveys were analyzed. The geographic distribution of respondents correlated with population concentrations of the United States (r = 90.8%, p <.0001). Most responding physicians (46/57; 80.7%) reported being a member of NSTs, compared with 56.5% (88/156) of dietitians. Of those not practicing in NSTs (N = 81/235, 34.4%), 12.3% (10/81) reported an NST was previously present at their institution but had been disbanded. Regarding NSTs, financial concerns were common (115/235; 48.9%), followed by leadership (72/235; 30.6%), and healthcare professional (HCP) interest (55/235; 23.4%). A majority (173/235; 73.6%) of all respondents wanted additional training in nutrition but reported insufficient protected time, ability to travel, or support from administrators or other HCPs. Conclusion: Core actions resulting from this survey focused on formalizing physician roles, increasing interdisciplinary nutrition support expertise, utilizing cost-effective screening for malnutrition, and implementing intervention protocols. Additional actions included increasing funding for clinical practice, education, and research, all within an expanded portfolio of pragmatic nutrition support care models.
KW - chronic care model
KW - malnutrition
KW - medical economics
KW - medical nutrition
KW - nutrition
KW - nutrition support
KW - nutrition support teams
KW - reimbursement
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U2 - 10.1002/jpen.2326
DO - 10.1002/jpen.2326
M3 - Article
C2 - 35040154
AN - SCOPUS:85133543915
SN - 0148-6071
VL - 46
SP - 1709
EP - 1724
JO - Journal of Parenteral and Enteral Nutrition
JF - Journal of Parenteral and Enteral Nutrition
IS - 7
ER -