Identification and management of malnutrition in the community: the perspective of the multidisciplinary team and patients (Dr Sarah Browne)

Malnutrition occurs frequently among community-dwelling individuals in developed countries. Once identified, it can be effectively treated in most cases with dietary advice and oral nutritional supplements (ONS). Previous research has reported inadequate screening and treatment of malnutrition in the community.

In the ONSPres Malnutrition study, healthcare professionals (HCPs) working in primary care and community settings and patients with a previous or current prescription for ONS were interviewed to explore their views of malnutrition management and ONS use. This involved face-to-face interviews with general practitioners and patients, and profession-specific focus groups with community and industry dietitians, nurses, pharmacists, physiotherapists, occupational therapists, and speech and language therapists.

A dislike of the term “Malnutrition” was identified among HCPs and patients, with patients clearly misunderstanding and fearful of the condition. HCPs reported gaps in the management of malnutrition and uncertainty about the care pathway. The lack of resources and need for dietetic support was highlighted. Patients relied on friends and family to manage malnutrition, perceived a disconnect between multidisciplinary care team members and reported little dietetic input. HCPs reported a lack of knowledge about how to manage malnutrition and appropriate ONS prescribing and use. Concerns were expressed about perceived costs, poor monitoring and compliance, and inappropriate prescribing in residential care.

HCPs working in the community are overwhelmed and underequipped to manage malnutrition and patients require further support. Clarity around malnutrition management pathways, improved multidisciplinary communication and greater dietetic support for those who are malnourished or at risk of malnutrition in the community is urgently required.