Information & Literature
‘National Primary Care Cooperation Agreement Undernutrition’ has been developed by the NHG (general practitioners), V&VN (nursepractitioners) and NVD (dieticians). The agreement is designed to achieve better primary care for adults with or at risk of malnutrition by creating closer cooperation between GPs, nurses and dieticians. This requires tasks and responsibilities regarding detection, diagnosis, treatment and support to be divided. The goal is to have the most suitable care provider(s) provide the right care at the right time and to safeguard continuity of care for the patient.
GPs and nurses must remain vigilant for malnutrition in:
- Vulnerable elderly patients at home, in care homes or in residential care.
- Patients with multiple illnesses, chronic conditions or using multiple medications.
- Patients with physical limitations.
- Patients with poorly fitted dentures, difficulties with chewing or swallowing.
- Patients (particularly older and seriously ill patients) recently discharged from the hospital.
- Patients with psychosocial difficulties and neglect.
- Patients with alcohol or drug abuse.
Care provider considerations
This LESA makes recommendations for cooperation and suggestions for working agreements between GPs, dietitians and nurses. The goal is to have most suitable care provider(s) provide the patient with the right care at the right time and to safeguard continuity of care. The care provider’s personal insights remain important, however. In certain concrete situations, well-argumented deviation from the LESA may be justified.
Malnutrition screening among nursing home residents is often performed with tools developed for use among older subjects, and sometimes with tools designed for an adult population. Only a few tools have been designed specifically for the nursing home setting. This systematic review assesses the criterion and predictive validity of malnutrition screening tools used in nursing homes.
PROMISS stands for “PRevention Of Malnutrition In Senior Subjects in the EU”. In Europe, 90-95% of older adults live at home. Among them, about 21% is malnourished or at risk of malnutrition. PROMISS therefore aims at conducting research on prevention of malnutrition among older persons living at home, thus providing concrete recommendations for an active and healthy life-style also in later years. To achieve this mission, a multi-disciplinary international consortium will pursue the following objectives, divided in two phases: the understanding of the context and, based on this, the development of solutions to prevent malnutrition. Click here to view the website.
- Schilp 2013. Effects of a dietetic treatment in older, undernourished, community-dwelling individuals in primary care: a randomized controlled trial
- Mijnarends 2013. Validity and Reliability of Tools to Measure Muscle Mass, Strength, and Physical Performance in Community-Dwelling Older People: A Systematic Review
- Wijnhoven 2013. Reproducibility of measurements of mid-upper arm circumference in older persons
- Schilp 2012. High prevalence of undernutrition in Dutch community-dwelling older individuals
- Wijnhoven 2012. Region-Specific Fat Mass and Muscle Mass and Mortality in Community-Dwelling Older Men and Women
- Van Asselt 2012. Assessment and treatment of malnutrition in Dutch geriatric practice: consensus through a modified Delphi study
- Schilp 2011. Early determinants for the development of undernutrition in an older general population: Longitudinal Aging Study Amsterdam
- Op den Kamp 2009. Muscle atrophy in cachexia: can dietary protein tip the balance?
- Van Wayenburg 2009. Improving nutritional management within high-risk groups
- Van Wayenburg 2005. Nutritional deficiency in Dutch primary care: data from general practice research and registration networks
- Wijnhoven 2012. Development and validation of the SNAQ65+
- Wijnhoven 2010. Low Mid-Upper Arm Circumference, Calf Circumference, and Body Mass Index and Mortality in Older Persons
- Steuten 2006. COPD as a multicomponent disease: Inventory of dyspnoea, underweight, obesity and fat free mass depletion in primary care