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HOMEFOOD Randomised Trial–Six-Month Nutrition Therapy in Discharged Older Adults Reduces Hospital Readmissions and Length of Stay at Hospital Up to 18 Months of Follow-Up

  • Original Research
  • Published:
The journal of nutrition, health & aging

Abstract

Background

Malnutrition is frequently observed in older adults and is associated with hospital readmissions, length of stay (LOS), and mortality in discharged patients.

Objective

The aim of this study was to investigate effects of six-month nutrition therapy on hospital readmissions, LOS, mortality and need for long-term care residence 1-, 6-, 12- and 18-months post-discharge in older Icelandic adults.

Design

Secondary analysis of a randomized controlled trial.

Paarticipants

Participants (>65 years) were randomised into intervention (n=53) and control (n=53) before discharge from a geriatric unit.

Intervention

The intervention group received nutrition therapy based on the Nutrition Care Process, including home visits, phone calls, freely delivered energy- and protein-rich foods and supplements for six months after hospital discharge.

Measurements

The Icelandic electronic hospital registry was accessed to gain information on emergency room visits (ER), hospital readmissions, LOS, mortality and need for long-term care residence.

Results

The intervention group had a lower proportion of participants with at least one readmission compared to control (1 month: 1.9% vs 15.8%, P=0.033; 6 months: 25.0% vs 46.2%, P=0.021; 12 months: 38.5% vs 55.8%, P=0.051; and 18 months: 51.9% vs 65.4%, P=0.107). There was also a lower total number of readmissions per participant (1 month: 0.02 vs 0.19, P=0.015; 6 month: 0.33 vs 0.77, P=0.014; 0.62 vs 1.12, P=0.044) and a shorter LOS (1 month: 0.02 vs 0.92, P=0.013; 6 months: 2.44 vs 13.21; P=0.006; 12 months: 5.83 vs 19.40, P=0.034; 18 months: 10.42 vs 26.00, P=0.033) in the intervention group. However, there were no differences between groups in ER visits, mortality and need for long-term care residence.

Conclusion

A six-month nutrition therapy in older Icelandic adults discharged from hospital reduced hospital readmissions and shortens LOS at the hospital up to 18-months post-discharge. However, it did neither affect mortality, ER, nor need of long-term care residence in this group.

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Acknowledgement: The authors want to thank the study staff for their dedicated work, i.e., Ósk Guðmundsdóttir, Elfa Björk Rúnarsdóttir, and Gunnhildur Olga Jónsdóttir as well as the Icelandic food companies Sláturfélag Suðurlands Ltd., Grimur kokkur Ltd., and MS Iceland Dairies for the collaboration and delivery of food items. The authors want to state that neither the above-mentioned funding entities nor the food companies were involved in study design, -conduct, statistical analysis, or paper writing.

Funding

Funding statements: The study was funded by the Icelandic Research Fund (174250-051), the Research Fund of the University of Iceland, the Research Fund of Hrafnista, Research Fund of Hrafnista, and the Helga Jonsdottir and Sigurlidi Kristjansson Geriatric Research Fund. The grants were provided without any conditions.

Author information

Authors and Affiliations

  1. Faculty of Food Science and Nutrition, University of Iceland, Aragata 14, 101, Reykjavik, Iceland

    Berglind Soffia Blondal, O. G. Geirsdottir, T. I. Halldorsson & A. Ramel

  2. The Dietetic and Nutritional Research Unit, EATEN, Herlev and Gentofte University Hospital, Herlev, Denmark

    A. M. Beck

  3. The Icelandic Gerontological Research Institute, Reykjavik, Iceland

    P. V. Jonsson

  4. Faculty of Medicine, School of Health, University of Iceland, Reykjavík, Iceland

    P. V. Jonsson

  5. Department of Geriatrics, The National University Hospital of Iceland, Reykjavík, Iceland

    P. V. Jonsson

Authors
  1. Berglind Soffia Blondal
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  2. O. G. Geirsdottir
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  3. T. I. Halldorsson
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  4. A. M. Beck
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  5. P. V. Jonsson
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  6. A. Ramel
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Corresponding author

Correspondence to Berglind Soffia Blondal.

Ethics declarations

Conflict of interest: Blondal BS: no conflict of interest. Geirsdottir OG: no conflict of interest. Halldorsson TI: no conflict of interest. Beck AM: no conflict of interest. Jonsson PV: no conflict of interest. Ramel A: no conflict of interest.

Ethical standards’ declaration: This study complied with the current laws of Iceland in which it was conducted.

Additional information

Statement of Authorship: BSB and AR did the investigation; BSB and AR performed formal analysis; BSB and AR were accountable for project administration; BSB, OGG, AMB, PVJ, TIH, and AR wrote the paper; OGG, AMB, and AR were responsible for conceptualisation; OGG and AR were responsible for supervision; OGG, AMB, PVJ, and TIH reviewed the paper; BSB and AR did the funding acquisition; AR was responsible for methodology.

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Blondal, B.S., Geirsdottir, O.G., Halldorsson, T.I. et al. HOMEFOOD Randomised Trial–Six-Month Nutrition Therapy in Discharged Older Adults Reduces Hospital Readmissions and Length of Stay at Hospital Up to 18 Months of Follow-Up. J Nutr Health Aging 27, 632–640 (2023). https://doi.org/10.1007/s12603-023-1962-5

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  • DOI: https://doi.org/10.1007/s12603-023-1962-5

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