Nutrition Care after Discharge from Hospital: An Exploratory Analysis from the More-2-Eat Study

TLDR

Many patients leave hospital in poor nutritional states, and little is known about the nutrition care they receive after discharge. The study aims to describe 30‑day post‑discharge nutrition‑care activities reported by patients and identify covariates associated with those activities. A quasi‑random sample of 513 Canadian medical‑unit patients was followed for 30 days after discharge, with 48.5% completing a telephone interview that collected self‑reported use of nutrition recommendations and oral nutritional supplements and performed bivariate analyses of associated covariates. Among participants, 42% received discharge nutrition recommendations, 65% of whom followed them, 26.5% used oral nutritional supplements, and those who followed recommendations were more likely to adopt a special diet while supplement users were more likely to be at nutrition risk, malnourished, have lower hand‑grip strength, and doubt their intake adequacy, providing new insights into post‑discharge nutrition care.

Abstract

Many patients leave hospital in poor nutritional states, yet little is known about the post-discharge nutrition care in which patients are engaged. This study describes the nutrition-care activities 30-days post-discharge reported by patients and what covariates are associated with these activities. Quasi-randomly selected patients recruited from 5 medical units across Canada (n = 513) consented to 30-days post-discharge data collection with 48.5% (n = 249) completing the telephone interview. Use of nutrition care post-discharge was reported and bivariate analysis completed with relevant covariates for the two most frequently reported activities, following recommendations post-discharge or use of oral nutritional supplements (ONS). A total of 42% (n = 110) received nutrition recommendations at hospital discharge, with 65% (n = 71/110) of these participants following those recommendations; 26.5% (n = 66) were taking ONS after hospitalization. Participants who followed recommendations were more likely to report following a special diet (p = 0.002), different from before their hospitalization (p = 0.008), compared to those who received recommendations, but reported not following them. Patients taking ONS were more likely to be at nutrition risk (p < 0.0001), malnourished (p = 0.0006), taking ONS in hospital (p = 0.01), had a lower HGS (p = 0.0013; males only), and less likely to believe they were eating enough to meet their body’s needs (p = 0.005). This analysis provides new insights on nutrition-care post-discharge.