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.

Ongoing projects:

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.

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