Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: results from an international survey

Huysentruyt, K., Hulst, J., Bian, F., Shamir, R., White, M., Galera-Martinez, R., Morais-Lopez, A., Kansu, A. and Gerasimidis, K. (2019) Opinions and practices of healthcare professionals on assessment of disease associated malnutrition in children: results from an international survey. Clinical Nutrition, 38(2), pp. 708-714. (doi: 10.1016/j.clnu.2018.03.015) (PMID:29653864)

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Abstract

Background & aims: Lack of consensus on clinical indicators for the assessment of pediatric disease associated malnutrition (DAM) may explain its under-recognition in clinical practice. This study surveyed the opinions of health professionals (HP) on clinical indicators of DAM and barriers impeding routine nutritional screening in children. Methods: Web-based questionnaire survey (April 2013–August 2015) in Australia, Belgium, Israel, Spain, The Netherlands, Turkey and UK. Results: There were 937 questionnaires returned via local professional associations, of which 693 respondents fulfilled the inclusion criteria and were included in the final analysis; 315 pediatric gastroenterologists and 378 pediatric dieticians. The most important clinical indicators of DAM were ongoing weight loss (80.4%), increased energy/nutrient losses (73.0%), suboptimal energy/macronutrient intake (68.6%), a high nutritional risk condition (67.2%) and increased energy/nutrient requirements (66.2%). These findings were consistent across countries and professions. The most common approach to screen for DAM was assessment of weight changes (85%), followed by the usage of growth charts (77–80%). Common perceived barriers for routine nutritional screening/assessment were low staff awareness (47.5%), no local policy or guidelines (33.4%) and lack of time to screen (33.4%). Conclusions: HP who routinely assess and treat children with DAM identified ongoing weight loss, increased losses, increased requirements, low intake and high nutritional risk conditions as the most important clinical indicators of DAM. These clinical indicators should now serve as a basis to form clinical-based criteria for the identification of DAM in routine clinical practice. Low awareness, lack of guidelines or local policy and lack of resources were the most important barriers of routine screening.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Gerasimidis, Professor Konstantinos
Authors: Huysentruyt, K., Hulst, J., Bian, F., Shamir, R., White, M., Galera-Martinez, R., Morais-Lopez, A., Kansu, A., and Gerasimidis, K.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Clinical Nutrition
Publisher:Elsevier
ISSN:0261-5614
ISSN (Online):1532-1983
Published Online:05 April 2018
Copyright Holders:Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism
First Published:First published in Clinical Nutrition 38(2):708-714
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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