Guideline on malnutrition (2017)
Aim of guideline
The aim of this malnutrition guideline is a timely, optimal and uniform recognition and treatment of malnutrition related to disease and ageing.
The first chapter of the guideline covers definitions, risk indicators, different types of malnutrition, and the causes, consequences and prevalence of malnutrition. The second chapter contains information about recognising and diagnosing it, while the third chapter explores treatment, evaluation and monitoring. In the fourth chapter, transmural, multidisciplinary collaboration is discussed.
The patient population to which this guideline applies consists of adults at risk of malnutrition or already suffering from malnutrition in all sectors of Dutch healthcare. This guideline does not apply to children nor to adults who are not being treated by a healthcare professional. The contents of this guideline are in line with the contents of existing guidelines on related topics (for example, the malnutrition among geriatric patients guideline (2013), malnutrition and cancer guideline (2012), various ESPEN guidelines).
Users of the guideline
The target group for this guideline consists of all healthcare professionals who can recognise and treat adults suffering from or at risk of malnutrition. The last chapter addresses the multidisciplinary distribution of tasks and responsibilities.
The authors and approval by the members of the Malnutrition Steering Group
The authors come for the relevant professional groups: dietetics, internal medicine, gastroenterology, nursing, nutritional science and kinesiology. The guideline has been approved by the members of the adult section and the scientific advisory council of the Malnutrition Steering Group. These groups contain representatives from the fields of general medicine, dietetics, nursing, geriatrics, internal medicine, nutritional science, kinesiology, healthcare management, pharmacology and paediatrics.
The guideline was written without project financing, and its contents were not influenced by the opinions or interests of individuals or institutions. There are no conflicts of interests among the authors or the members of the Malnutrition Steering Group.
This guideline is narrative in nature. No systematic literature review was done as the subject and the field are too broad. Not enough good-quality research has been done to be able to produce evidence-based conclusions. Nevertheless, it is necessary to offer suggestions for individual patient healthcare. This guideline can be helpful in that respect.
The most recent literature and insights have been included. Consensus was achieved after discussions and several written rounds of revision. The evidentiary value has not been specified for each recommendation, but scientific support is provided. When there is insufficient evidentiary value (only based on expert opinions or research that is not comparable), this is stated. The main recommendations in each chapter are summarised in boxes.