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Discharged on Enteral Nutrition: What Now? The Poor State of Outpatient Support for Patients on Enteral Nutrition Support

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Abstract

Purpose of Review

While the use of enteral nutrition (EN) has increased, and more medical centers have developed inpatient programs to address the unique needs of these patients, our collective experience at a few large institutions indicates that there is very little systemic support for patients after discharge. Here, we discuss what we have observed to be some of the barriers to providing outpatient follow up care, summarize the impact we have seen on patients, and propose some possible solutions.

Recent Findings

We have observed and identified some of the root causes to include financial barriers; uncoordinated care transitions; high complexity of care, including medication management; and diffuse leadership to a multidisciplinary problem.

Summary

Systematic support for outpatient care for patients discharged on enteral nutrition is rare and limited, due to many root causes. There are a few tools and tips that we have summarized here for individual providers, and a few promising methods in development, but a systematic approach is in great need.

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Authors and Affiliations

  1. Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA

    Sonali Palchaudhuri

  2. Hospital of the University of Pennsylvania, Philadelphia, PA, USA

    Brigid Mccreary

  3. UofL Health - UofL Hospital, Louisville, KY, USA

    Jessica Davis

  4. Penn Medicine Center for Health Care Innovation, Philadelphia, PA, USA

    Brenna Mcginnis & Susan Nyberg

  5. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA

    Manpreet S. Mundi

  6. Division of Gastroenterology, Hepatology and Nutrition, University of Florida, Gainesville, FL, USA

    Angela Pham

Authors
  1. Sonali Palchaudhuri
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  2. Brigid Mccreary
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  3. Jessica Davis
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  4. Brenna Mcginnis
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  5. Susan Nyberg
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  6. Manpreet S. Mundi
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  7. Angela Pham
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Corresponding author

Correspondence to Sonali Palchaudhuri.

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Conflict of Interest

Brigid McCreary declares that she has no conflicts of interest.

Brenna McGinnis declares that she has no conflicts of interest.

Susan Nyberg declares that she has no conflicts of interest.

Jessica Davis declares that she has no conflicts of interest. 

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding

Sonali Palchaudhuri participated in the Nestle Nutrition Institute Clinical Nutrition Fellowship.

Manpreet Mundi has received research grants from Fresenius Kabi, Nestle, Vectiv Bio, and Rockfield. He serves on the advisory board for NorthSea.

Angela Pham has received research grants from Pfizer.

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Palchaudhuri, S., Mccreary, B., Davis, J. et al. Discharged on Enteral Nutrition: What Now? The Poor State of Outpatient Support for Patients on Enteral Nutrition Support. Curr Gastroenterol Rep 25, 61–68 (2023). https://doi.org/10.1007/s11894-023-00864-x

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