Personalized Dietary Advice After Discharge From Hospital in Geriatrics: Factors Associated With Improved Nutritional Status and Autonomy

Not Applicable

• Conditions: Undernutrition of Elderly Peopole
• Interventions: Dietary Supplement: Personalized dietary management at home

• Registration Number: NCT04016532
• Lead Sponsor: Gérond'if

Brief Summary

The purpose of this study is to identify the factors associated with the effectiveness of home dietary management in these elderly people returning home (personal home or independent residence) after hospitalization in acute geriatrics.

Detailed Description

Patient recruitment will be carried out in the 6 participating hospital centres.

All patients willing to participate, will benefit from an Inclusion Visit (J0): Conducted in hospital in acute geriatric services before discharge from hospital. Verification of inclusion criteria, collection of patient consent by investigator, assignment of patient identification number, declaration of inclusion, and collection by investigator of inclusion data (age, sex, weight, height, appetite, dietary intake scale, risk factors for undernutrition by HAS, albumin, CRP, exit treatment, ADL, IADL and GIR, technical aids for walking, presence of professional and non-professional home workers).

Home visit J7 (30 min to 1 hour): initial dietary assessment, will be carried out between 24 hours and 7 days after discharge from hospital. During this visit, the dietician will perform several measurements (MNA-SF, weight, height, appetite assessment, ingest/24h Consumption of NOCs if prescribed in hospital, Quality of Life, ADL, IADL, acceptance of visit, follow-up of dietary advice and intercurrent medical events).

Home visit J30, J60 (30 min to 1h): Made by the dietician, during these visits will be carried out various measurements and questionnaires: Appetite assessment, weight, ingesta/24h, consumption of NOCs, acceptance of the visit, follow up on dietary advice, compendiums of intercurrent medical events.

Home visit J90 = Final visit. This visit is identical to the initial assessment (J7). Patients who are undernourished or at risk of undernutrition will receive an additional J15 home visit (15 days after discharge from hospital). This visit will be identical to visits J30, J60.

Study Timeline

• Study Start: 2019-06-25
• Study First Submitted: 2019-07-03
• Study First Submitted QC: 2019-07-10
• Study First Posted: 2019-07-11
• Status Verified: 2022-04
• Last Update Submitted: 2023-01-11
• Last Update Posted: 2023-01-12
• Primary Completion: 2023-06
• Study Completion: 2023-09

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 338

Inclusion Criteria

• Unscheduled hospitalization of at least 4 days in acute geriatrics,
• Direct return to home or independent residence after hospitalization,
• To be domiciled in the Hauts-de-Seine department,
• Good understanding of the French language,
• Beneficiary of a social security scheme,
• Having read the briefing note and having consented to participate in the study by signing a written consent,

Exclusion Criteria

• Severe cognitive impairment according to DMS-IV criteria,
• Inflammatory syndrome (CRP > 30 mg/l)
• Evolving cancer;
• Chronic respiratory failure,
• Stage IV heart failure
• long-term corticosteroids (> 10 mg/d prednisolone or equivalent),
• Enteral and parenteral nutrition at home,
• Chronic end-stage pathology;
• Inability to walk without human help
• Major person subject to a legal protection measure (guardianship, guardianship and safeguarding of justice)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Not undernourished patients	Personalized dietary management at home	Dietary follow-up at home: 3 visits ( D30,D60, D90)
Patient malnourished or at risk of undernutrition	Personalized dietary management at home	Dietary follow-up at home: 4 visits (D15, D30, D60, D90)

Primary Outcome Measures

Name	Time	Method
Screening for undernutrition in geriatric practice according the MNA-SF score (Short-Form Mini-Nutritional Assessment)	3 months

Secondary Outcome Measures

Name	Time	Method
Assessment of the appetite according the VAS scale "Visual Analog Scale"	3 months
Assessment of teh degree of autonomy according AGGIR score	Inclusion (0 day)
Assessment of patient's level of dependence through an appreciation of instrumental activities of daily living according Lawton scale	3 months
Assessment of the degree of patient dependence according "Index of Independence in Activities of Daily Living" KATZ scale	3 months
Grab force measurement according the dynamometer	3 months

Trial Locations

Locations (1)

Geriactric Departement, Rives de Seine hopsital; 🇫🇷 Courbevoie, Ile-De-France, France