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Strategies to Identify and Manage Malnutrition in the Community:


A difference of opinion? A review of locally-developed oral nutrition support guidance across the UK


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with this article


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Anne Holdoway, Specialist Dietitian in Gastroenterology & Nutrition Support, and Chair - PEN Group of the BDA


Introduction The profile of malnutrition and the importance of its identification and management has been raised since the launch of the National Institute for Health and Clinical Excellence (NICE) guidelines in 2006.1


In response to these guidelines, many locally


developed nutrition support policies have been put in place.These have been developed by a variety of healthcare professionals, with differing opinions on how to manage malnutrition.This article outlines the background and results of a review of oral nutrition support policies and guidance available across the UK.


Malnutrition (under-nutrition) in the UK is a common and costly problem2


with detrimental


effects on both clinical outcomes (delayed recovery from illness, reduced strength and quality of life)3 and the wider health economy (more GP visits, re- admissions, support required post discharge, and longer hospital stay).4


Disease related malnutrition is


estimated to affect around three million people in the UK, with the majority living in the community (93%).2


Overall, public health expenditure on malnutrition has been estimated to be in excess of £13 billion per annum.2


In 2006, NICE published Clinical Guideline 32:


Nutrition support in adults, recommending strategies to implement evidence based nutritional care for adults.1


The guidance includes a systematic


review of the evidence and a costing template for NHS Trusts to assess the impact of the guidelines on


their own budget. NICE (Nov 2011) ranked CG32 third in the list of clinical guidance that could generate the most savings. NICE highlighted that if CG32 were fully implemented and patients were screened, assessed and treated and this resulted in better nourished patients, savings could be achieved through reduced complications, reduced admissions, reduced length of stay and reduced GP and outpatient services.5


CN Focus Vol.4 No.1 April 2012 | 11


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