Malnutrition Clinical Trial
Malnutrition affects until 70% of the patients hospitalized in geriatric's units and
constitutes an independent risk factor of morbidity and mortality. Malnutrition is also
associated with increased length of stay and increased costs, and alters the quality of
life. Oral nutritional supplements (ONS) play a key role in the prevention and treatment of
malnutrition in older people. ONS are a simple way to offer in a small volume a nutritional
supply with a high density of calorie and protein. The clinical efficiency of ONS is well
demonstrated whether on nutritional parameters or on clinical outcomes. However,
acceptability and consumption of these ONS are frequently suboptimal: in geriatrics, only
50% to 65% of the prescribed volumes of ONS are consumed. The reasons are multiple:
anorexia, taste changes, monotony … also partly because patients dislike flavor, taste or
texture. The respect of patients' preferences is essential to improve the therapeutic
observance to ONS. Generally, ONS are delivered after the patient has told his preferences
orally to the dietitian. To date, there is no study evaluating the effect of an alternative
strategy based on a preliminary degustation of several products on the effective consumption
of ONS in geriatrics.
The study is designed as prospective, randomized, controlled, open study to test this
strategy in older undernourished people hospitalized in geriatrics who require prescription
of ONS. This study will be performed among 220 older people hospitalized in two departments
of geriatrics of the AP-HM (Assistance Publique - Hôpitaux de Marseille).
The main objective is to compare the therapeutic observance to ONS when products are
delivered to older people according to the usual way (preferences announced orally and/or
dietitian's choice) or according to an alternative strategy based on a preliminary
degustation of several products varying for flavor and texture but always in respect of the
medical prescription. The secondary objective is to compare the evolution of the nutritional
status estimated by routinely used clinical and biological parameters, as well as the main
clinical outcomes during the hospital stay. Lastly, the nutritional status of these patients
will be reevaluated clinically 3 months after the hospital's discharge.
The hypothesis is that a strategy based on a preliminary degustation, leading to an informed
choice, will significantly improve the acceptability and the effective consumption of ONS
during the hospital stay, and will also impact positively the nutritional status at
hospital's discharge and 3 months after. The validation of this hypothesis could allow
recommending the generalization of preliminary degustation of ONS at the time of their
prescription to optimize the therapeutic observance in undernourished older people.
n/a
Intervention Model: Single Group Assignment, Masking: Open Label
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