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Gegevensoverdracht rond ondervoede patiënt: berichtgeving is mager

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Huisarts en Wetenschap Aims and scope

Samenvatting

Klinkenberg M, Van Binsbergen JJ, Strack van Schijndel RJM, Thijs A, Van Bokhorst-de van der Schueren MAE. Gegevensoverdracht rond ondervoede patiënten: berichtgeving is mager. Huisarts Wet 2005;48(5):216-9.

Doel Inzicht krijgen in de plaats die voedingszorg inneemt in de informatieoverdracht tussen huisarts en specialist.

Opzet Prospectief cohortonderzoek bij patiënten opgenomen op de afdelingen inwendige geneeskunde in een academisch ziekenhuis.

Methode Gedurende twee maanden werden alle nieuw opgenomen patiënten gescreend op ondervoeding. We analyseerden verwijsbrieven van huisarts naar specialist en ontslagbrieven van specialist naar huisarts op overdracht van voedingszorg. Drie maanden na ontslag vroegen wij aan de huisartsen van de ondervoede patiënten een vragenlijst over voedingstoestand en voedingszorg van de patiënt in te vullen.

Resultaten Honderdenzes patiënten werden geïncludeerd van wie er 70 participeerden in het onderzoek (66% respons). Hiervan was een derde (n=24) in een slechte voedingstoestand. In de dossiers van de ondervoede patiënten kwamen zeven verwijsbrieven van de huisarts voor; drie daarvan bevatten informatie over de voeding(stoestand). In de ontslagbrieven werd in 40% van de gevallen geen enkele mededeling gedaan over het gewicht, de voedingstoestand of het voedingsbeleid. In de andere gevallen bestond de informatie uit een enkele opmerking, zonder dat gerichte voedingsadviezen werden gegeven. Complicaties en heropnames kwamen vaak voor en huisartsen bleken drie maanden na ontslag niet of onvoldoende op de hoogte van de voedingstoestand van hun patiënten.

Conclusie De overdracht van voedingszorg tussen huisarts en specialist was niet gestructureerd en onvolledig.

Abstract

Klinkenberg M, Van Binsbergen JJ, Strack van Schijndel RJM, Thijs A, Van Bokhorst-de van der Schueren MAE. Exchange of information on malnourished patients: reporting is scarce. Huisarts Wet 2005;48(5):216-9.

Objective To obtain insight into the exchange of information on nutritional status and nutritional support between hospital and general practitioner.

Design Prospective cohort study in newly admitted patients to the internal medicine department of a teaching hospital.

Method Nutritional status was assessed in all patients admitted to the Internal Medicine department VU University Medical Center (Amsterdam) over a period of 2 months. Malnourished patients’ letters of referral and discharge were analysed for exchange of nutritional information between clinicians and GPs. The GP filled in a short questionnaire regarding the malnourished patients three months after discharge (n=13).

Results 106 patients were eligible to be included in the study, 70 patients participated (66% response), 24 patients were malnourished (34%).

In seven cases a GP referral was found in the medical record, three of which included nutritional information. The discharge letters contained no information on body weight, nutrition or nutritional status in 40% of the cases. In the other cases only fragmentary notes referring to nutrition were included. No advice for follow-up was given in order to support nutrition after discharge. Re-admission to hospital occurred frequently in the malnourished patients and GPs were scarcely aware of their patients’ nutritional status three months after discharge (n=13).

Conclusion Exchange of information on nutritional status and treatment between hospital and GP was unsystematic and poor.

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  1. www.bsl.nl/shop/huisarts-en-wetenschap-0018-7070.html

    M Klinkenberg

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  1. M Klinkenberg
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  2. JJ van Binsbergen
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  3. RJM Strack van Schijndel
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  4. A Thijs
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  5. MAE van Bokhorst-de van der Schueren
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Additional information

VU medisch centrum, dienst diëtetiek en voedingswetenschappen, Postbus 7057, 1007 MB Amsterdam: dr. M.A.E. van Bokhorst-de van der Schueren, hoofd van dienst; dr. M. Klinkenberg, senioronderzoeker; afdeling Intensive care volwassenen: R.J.M. Strack van Schijndel, internist-intensivist; afdeling algemene interne geneeskunde: A. Thijs, internist; UMC St Radboud Nijmegen: prof.dr. J.J. van Binsbergen, hoogleraar Voedingsleer en Huisartsgeneeskunde.

Mogelijke belangenverstrengeling: De leerstoel van JvB wordt gefinancierd door de Zuivelstichting. MvB ontving in het verleden vergoedingen van de voedingsindustrie voor het geven van lezingen en participatie in onderzoek. De tijdelijke aanstelling van MK is gedeeltelijk gefinancierd door Nutricia Nederland BV.

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Klinkenberg, M., van Binsbergen, J., van Schijndel, R.S. et al. Gegevensoverdracht rond ondervoede patiënt: berichtgeving is mager. HUWE 48, 684–688 (2005). https://doi.org/10.1007/BF03084416

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