PMID- 36619321
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230111
IS  - 2516-5542 (Electronic)
IS  - 2516-5542 (Linking)
VI  - 5
IP  - 2
DP  - 2022 Dec
TI  - Impact of a multidisciplinary nutritional support team on quality improvement for 
      patients receiving home parenteral nutrition.
PG  - 286-296
LID - 10.1136/bmjnph-2022-000484 [doi]
AB  - INTRODUCTION: Home parenteral nutrition (HPN) is essential for patients with 
      intestinal failure requiring long-term nutritional support. The Amerita Quality 
      Improvement Project for HPN Patients (QIP-PN) explored the effect of a physician 
      nutrition expert (PNE)-led multidisciplinary nutritional support team (MNST) on 
      HPN care for patients under its service. OBJECTIVE: To determine an MNST effect 
      on adherence to protocols, outcomes and quality of life (QOL) in HPN. METHODS: 
      The study was divided into three phases: data review (phases 1a and 1b), 
      observation (phase 2) and intervention (phase 3). Seven Amerita locations were 
      selected as 'study branches' (population), from which all study patients and 
      controls were drawn. The quality improvement project employed a 
      quasi-experimental case-matched control group (control) design. Data were 
      collected on demographics, treating physicians PNE status, HPN care variables, 
      recommended interventions, quality-of-life assessment, adverse outcomes and 
      hospitalisations. Paired t-test compared continuous data between phases 2 and 3. 
      Comparisons between study and control groups used a negative binomial regression 
      model. RESULTS: Thirty-four patients were reviewed in phase 1a and 197 in phase 
      1b. Forty study patients completed phase 2 and progressed into phase 3, of whom 
      30 completed >/=60 therapy days. Patients were lost to follow-up if they 
      discontinued HPN for any reason. Improvements in weight, body mass index and QOL 
      were seen in the study patients during intervention. Recommendations made and 
      accepted by treating physicians differed based on PNE status. Study patients had 
      fewer adverse outcomes and related hospitalisations than controls. CONCLUSION: 
      MNST recommendations improved clinical, biochemical parameters and patients' 
      self-reported overall health. MNST input reduced adverse outcomes, 
      hospitalisation and the length of stay at the hospital. This study highlights the 
      potential for MNST to have a significant impact on the quality and overall cost 
      of HPN management.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Rothkopf, Michael
AU  - Rothkopf M
AUID- ORCID: 0000-0002-8975-5797
AD  - Department of Internal Medicine, Rutgers New Jersey Medical School, Newark, New 
      Jersey, USA.
FAU - Pant, Mohan
AU  - Pant M
AD  - School of Health Professions, Eastern Virginia Medical School, Norfolk, Virginia, 
      USA.
FAU - Brown, Rebecca
AU  - Brown R
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - Haselhorst, Jaimie
AU  - Haselhorst J
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - Gagliardotto, Francine
AU  - Gagliardotto F
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - Tallman, Allison
AU  - Tallman A
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - Stevenson, Debbie
AU  - Stevenson D
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - DePalma, Andrew
AU  - DePalma A
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - Saracco, Michael
AU  - Saracco M
AD  - Sea Meadows, LLC, Brick, NJ, USA.
FAU - Rosenberg, Dan
AU  - Rosenberg D
AD  - Amerita, Inc, Denver, Colorado, USA.
FAU - Proudan, Vladimir
AU  - Proudan V
AD  - Atlantic Health System Inc, Florham Park, New Jersey, USA.
FAU - Shareef, Kishwar
AU  - Shareef K
AD  - Atlantic Health System Inc, Florham Park, New Jersey, USA.
FAU - Ayub, Nudrat
AU  - Ayub N
AD  - Atlantic Health System Inc, Florham Park, New Jersey, USA.
LA  - eng
PT  - Journal Article
DEP - 20221115
PL  - England
TA  - BMJ Nutr Prev Health
JT  - BMJ nutrition, prevention & health
JID - 101769223
PMC - PMC9813622
OTO - NOTNLM
OT  - Inflammatory bowel disease
OT  - Malnutrition
OT  - Nutrition assessment
OT  - Nutritional treatment
OT  - Precision nutrition
COIS- Competing interests: MR and MS are paid consultants for Amerita. RB, JH, FG, AT, 
      DS, AD and DR are paid employees of Amerita. MP, VP, KS and NA have no conflicts.
EDAT- 2023/01/10 06:00
MHDA- 2023/01/10 06:01
PMCR- 2022/11/15
CRDT- 2023/01/09 03:49
PHST- 2022/05/14 00:00 [received]
PHST- 2022/10/24 00:00 [accepted]
PHST- 2023/01/09 03:49 [entrez]
PHST- 2023/01/10 06:00 [pubmed]
PHST- 2023/01/10 06:01 [medline]
PHST- 2022/11/15 00:00 [pmc-release]
AID - bmjnph-2022-000484 [pii]
AID - 10.1136/bmjnph-2022-000484 [doi]
PST - epublish
SO  - BMJ Nutr Prev Health. 2022 Nov 15;5(2):286-296. doi: 10.1136/bmjnph-2022-000484. 
      eCollection 2022 Dec.