The Design of the Feeding Support Trial – does intensive feeding support improved nutritional status and outcome in acutely ill older in-patients?

Summary Introduction: Malnutrition has been estimated to cost the NHS £266 million a year because malnourished patients have longer hospital stays and increased morbidity. Malnutrition is particularly common in the elderly. Most attempts to reverse malnutrition in this group have used liquid supplements but the results have been disappointing; even under surveillance, ill older patients often do not take enough supplements to improve their nutritional status. In routine clinical practice the situation is worse because poor nutrition is often not recognized and compliance with supplements is low. Another approach is needed. Objective: To describe the protocol of The Feeding Support Trial which aims to examine whether health care assistants, trained to provide support with all aspects of feeding, can make a significant impact on nutritional intake and whether this improves outcome. Design: A randomized control trial designed to determine whether feeding support increases nutritional intake leads to measurable changes in nutritional status (body mass index, arm circumference, serum albumin) and leads to improved outcome (infection rate, Barthel score, length of stay and readmission rate). Setting: Three elderly medicine wards at Hammersmith Hospitals NHS Trust. The study commenced in June 1998. Subjects: The trial aims to recruit 1500 subjects (750 in each group).