Improving clinical outcome in patients with intestinal failure using individualised nutritional advice
Article first published online: 1 APR 2009
© 2009 The Authors. Journal compilation. © 2009 The British Dietetic Association Ltd 2009
Journal of Human Nutrition and Dietetics
Volume 22, Issue 4, pages 290–298, August 2009
How to Cite
Culkin, A., Gabe, S. M. and Madden, A. M. (2009), Improving clinical outcome in patients with intestinal failure using individualised nutritional advice. Journal of Human Nutrition and Dietetics, 22: 290–298. doi: 10.1111/j.1365-277X.2009.00954.x
- Issue published online: 10 JUL 2009
- Article first published online: 1 APR 2009
- home parenteral nutrition;
- information booklet;
- intestinal failure;
- patient knowledge
Background: Patients with intestinal failure are required to adhere to a complex regimen. Written information may increase knowledge leading to improvements in clinical outcomes. The present study aimed to evaluate the effectiveness of nutrition advice incorporating the use of a booklet.
Methods: Each patient completed a questionnaire evaluating their knowledge of the regime and quality of life and kept a diet and gastrointestinal output diary. The diary was assessed and they were given the booklet with a verbal explanation tailored to individual requirements. The booklet explained the causes of intestinal failure, diet and fluid recommendations in relation to intestinal anatomy, information on medications and long-term monitoring. Patients were reassessed at their next appointment using the same tools. The primary endpoint was an improvement in knowledge. Secondary endpoints were an improvement in oral nutritional intake, nutritional status, quality of life and the content of home parenteral nutrition.
Results: Forty-eight patients completed the study. Knowledge improved significantly after dietetic intervention in association with the provision of the booklet (P < 0.001). Oral energy (P = 0.04) and fat (P = 0.003) intake increased with an improvement in body mass index (P = 0.02). Patients on home parenteral nutrition showed a reduction in parenteral energy (P = 0.02), nitrogen (P = 0.003), volume (P = 0.02) and frequency (P = 0.003).
Conclusions: A booklet for patients with intestinal failure in conjunction with personalised dietary counselling improves knowledge and clinical outcomes.