Study circles improve the precision in nutritional care in special accommodations

BACKGROUND: Disease-related malnutrition is a major health problem in the elderly population, but it has until recently received very little attention, especially are management issues under-explored. By identifying residents at the risk of undernutrition (UN), appropriate nutritional care can be provided. OBJECTIVE: To investigate if study circles and policy documents improve the precision in nutritional care and decrease the prevalence of low or high body mass index (BMI). DESIGN: Pre and post-intervention study. SETTING: Special accommodations (nursing homes) within six municipalities were involved. PARTICIPANTS: In 2005, 1,726 (90.4%) of 1,910 residents agreed to participate and in 2007, 1,526 (81.8%) of 1,866 residents participated. INTERVENTION: Study circles in one municipality, having a policy document in one municipality and no intervention in four municipalities. MEASUREMENTS: Risk of UN was defined as involving any of: involuntary weight loss; low BMI; and/or eating difficulties. Overweight was defined as high BMI. RESULTS: In 2005 and 2007, 64% and 66% of residents, respectively, were at the risk of UN. In 2007, significantly more patients in the study circle municipality were accurately provided protein and energy enriched food (PE-food) compared to the no intervention municipalities. There was a decrease between 2005 and 2007 in the prevalence of low BMI in the study circle municipality, but the prevalence of overweight increased in the policy document municipality. CONCLUSIONS: Study circles improve the provision of PE-food for residents at the risk of UN and can possibly decrease the prevalence of low BMI. It is likely that a combination of study circles and implementation of a policy document focusing on screening and on actions to take if the resident is at UN risk can give even better results.