Over 220,000 New Zealanders at Risk of Malnutrition
9th November 2011
Over 220,000 New Zealanders at Risk of Malnutrition, Warns International Expert
New Zealand should adopt mandatory screening for malnutrition to ensure that the 220,000 people at risk are properly cared for, a visiting international expert in medical nutrition warned healthcare professionals and key opinion leaders at meetings in Auckland today.
Dr Rebecca Stratton, from the Institute of Human Nutrition, University of Southampton, UK and Nutricia UK says: `We estimate that over 220,000 people in New Zealand are at risk of malnutrition and most of them are in the community. Up to 40 per cent of patients in hospital are also at risk of malnutrition. Most of these people are over 65. Many will never get to hospital and we really need to identify them so that something can be done to help. The cost of obesity is less than half that of malnutrition yet obesity gets the headlines.
Speaking at meetings of healthcare professionals at Auckland City Hospital and in Parnell she adds: `We are working with GPs to put in place a simple system to identify who needs nutritional support. The family doctor has a really important role to play but they just do not know enough about the problem and we need to help them with that. I would like to see the dieticians association, nursing associations and GPs’ bodies work together to implement a framework that will work for New Zealand.
`The role of pharmacists is also important. With a set of scales and guidelines, they have the ability to screen at their premises, ask key questions and use their clinical judgement to refer onto a GP for proper treatment.’
Dr Stratton points out that during an economic downturn the lack of understanding about the clinical and economic benefits of treating malnutrition may lead to health care organisations limiting the use of oral nutritional supplements. This impacts groups who struggle to eat an adequate diet such as the elderly and those suffering from specific medical conditions such as dementia, alzheimer’s, cancer and cystic fibrosis.
Dr Stratton who played a key part in the development of a universal screening tool for malnutrition says: ‘Disease-related malnutrition is a prevalent condition that is exceedingly costly to society, yet despite this, most healthcare systems spend a very small proportion, typically less than 3% of national prescribing budgets on treating malnutrition. Poor recognition of malnutrition may lead to healthcare managers limiting the use of treatments to save money’.
Dr Stratton explains the necessary strategies: ‘To make sure that those at risk of malnutrition are identified and treated appropriately, there is a need to embed national and local policies into routine clinical practice. Along with adequate funding, these policies could drive mandatory malnutrition screening and the appropriate treatment of malnourished patients. The use of oral nutritional supplements (ready-made liquids) is the only form of oral nutrition support with a substantial evidence-base.’
Dr Stratton concludes: ‘We need to implement these strategies. Stopping the inappropriate use of oral nutritional supplements will save money but failing to use supplements or stopping supplements in those that need them will increase costs as patients suffer the consequences of malnutrition. We know that spending on oral nutritional supplements appropriately for those who need them can enable financial savings as individual patients’ outcome and recovery is improved.’
Dr Stratton is on her way to Melbourne to present this new evidence to the Australasian Society of Parenteral and Enteral Nutrition (AuSPEN) being held this week.