Nutrition resource available for clinicians, caregivers
Nutrition resource available for clinicians, caregivers
Varied information compiled in one source
The Washington, DC-based Nutrition Screening Initiative (NSI) has recently published The Role of Nutrition in Chronic Disease Care, which presents treatment strategies that clinicians and health plans can tailor to enhance the provision of chronic care.
"It’s geared toward the elderly and adults," notes Jane White, PhD, RD, a professor at the Department of Family Medicine Graduate School of Medicine at the University of Tennessee in Knoxville, and one of two American Academy of Family Physician representatives on the NSI technical review committee.
"The original focus [of NSI] was normal nutrition screening and assessment and trying to get people to eat, and increasingly we were asked What would you suggest for older people with the diet-related diseases," says White. "That led to the development of this document."
White notes that previously there was little easily accessible information available for clinicians to help them identify the nutritional needs of older people. As a result, The Role of Nutrition in Chronic Disease Care has the following multiple purposes:
• Shows the benefits to health plans.
White says the publication documents the benefits of nutrition screening and assessment in older people, information White and the NSI hopes will be put to good use.
"Certainly managed care offers the greatest promise for the routine incorporation of nutritional screening and assessment in a high-risk population in their standardized approach," she says.
Such routine screening for nutritional status could go a long way toward improving quality of life for elderly patients, says White.
"The real benefit of nutrition care is get to people before chronic and severe problems set in because you can compress morbidity and mortality into a shorter time frame," says White. "Instead of getting ill at 65 and remaining chronic until 85, you may be able to compress [the chronic illness stage] from 80 to 85, and extend the quality of life."
• Provides usable information for clinicians.
White notes that the clinical information and practice guidelines provided in the publications could be used by health care providers in a number of disciplines, for medicine and dietetics in both the social work and pharmacy setting.
The information provided in The Role of Nutrition in Chronic Disease Care was gathered from numerous sources, with each chapter in the publication listing the primary information from which the information came.
White is quick to note that the usefulness of the information provided in the publication is not in being original or ground-breaking, but instead its presentation in a single, usable source.
"The information has been there," she says. "What has not been there is its routine and systematic application. Data on the importance of nutrition, nutritional status, and nutritional intervention in chronic disease has been out there for many, many years, but a way to approach patients in a systematic fashion has not been there."
Infusion can play a vital role
White notes that in many cases enteral and parenteral nutrition can be life-saving measures for patients. Although the preferred intake of nutrition is through food, patients who are unable or unwilling to eat are prime candidates for infusion therapy, which can help alleviate or delay the onset of other medical complications.
"I think providing adequate nutrients delays a lot of the chronic problems, such as pressure sores, that we see in homebound, frail, and institutionalized people," notes White. "Toleration for various medical therapies is enhanced when people are fed appropriately. Resistance to infection is improved, and recurrence of diseases requiring re-admission is reduced when nutritional status is optimized."
Along these lines, The Role of Nutrition in Chronic Disease Care presents in-depth information in the following areas:
• Rationale for incorporating nutrition care in treatment plans.
• Data on disease prevalence.
• Subgroups at risk for malnutrition.
• Adverse health outcomes of malnutrition on people with illness.
• Treatment options and patient education materials.
• Specific topics covered include cancer, chronic obstructive pulmonary disease, dementia, diabetes, failure to thrive, hypertension, and osteoporosis.
The Nutrition Screening Initiative is a multi-disciplinary effort led by the American Academy of Family Physicians, The American Dietetic Association, The National Council on the Aging, and a diverse coalition of more than 25 national health, aging, nutrition, and medical organizations. The NSI was organized in 1989 to address the most rapidly increasing segment of the U.S. population, the elderly.
To request a copy of either the executive summary or full report of The Role of Nutrition in Chronic Disease Care, contact the NSI by calling (202) 625-1662, or writing to NSI, 1010 Wisconsin Ave., NW, Washington, DC 20007.
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