BACKGROUND: Malnutrition is underrecognized and underdiagnosed, despite high prevalence rates and associated poor clinical outcomes. The involvement of clinical nutrition experts, especially physicians, in the care of high-risk patients with malnutrition remains low despite evidence demonstrating lower complication rates with nutrition support team (NST) management. To facilitate solutions, a survey was designed to elucidate the nature of NSTs and physician involvement and identify needs for novel nutrition support care models.
METHODS: This survey assessed demographics of NSTs, factors contributing to the success of NSTs, elements of nutrition education, and other barriers to professional growth.
RESULTS: Of 255 respondents, 235 complete surveys were analyzed. The geographic distribution of respondents correlated with population concentrations of the United States (r = 90.8%, p < .0001). Most responding physicians (46/57; 80.7%) reported being a member of NSTs, compared with 56.5% (88/156) of dietitians. Of those not practicing in NSTs (N = 81/235, 34.4%), 12.3% (10/81) reported an NST was previously present at their institution but had been disbanded. Regarding NSTs, financial concerns were common (115/235; 48.9%), followed by leadership (72/235; 30.6%), and healthcare professional (HCP) interest (55/235; 23.4%). A majority (173/235; 73.6%) of all respondents wanted additional training in nutrition but reported insufficient protected time, ability to travel, or support from administrators or other HCPs.
CONCLUSION: Core actions resulting from this survey focused on formalizing physician roles, increasing interdisciplinary nutrition support expertise, utilizing cost-effective screening for malnutrition, and implementing intervention protocols. Additional actions included increasing funding for clinical practice, education, and research, all within an expanded portfolio of pragmatic nutrition support care models.
Bibliographical noteFunding Information:
Manpreet S. Mundi has research grant from Fresenius Kabi, Nestlé, Realfood Blends, and VectivBio and is a consultant for Baxter. Jeffrey I. Mechanick has received honoraria for lectures and program development from Abbott Nutrition and serves on the advisory boards for Goodsugar and Aveta. Life, L‐Nutra, and Twin Health. Berkeley N. Limketkai has a research grant from the Crohn's and Colitis Foundation. Allison B. Blackmer has performed consultative services for Wolters Kluwer, Pediatric and Neonatal Lexi‐Drugs. Dr Blackmer also served as a member of the Drug Utilization Review Board for the Colorado Department of Health Care Policy and Financing through March 2020. Ryan T. Hurt is a consultant for Nestlé and has research grants from Zealand. Ajay Jain is a consultant for Mirum Pharmaceuticals and CAMP4. Matthew B. Kaspar is on the speakers bureau of Takeda and has a spouse who is an employee of Alnylam Pharmaceuticals. Stephen A. McClave leads the Nestlé Fellowship. Chet A. Morrison reports having a spouse employed by Baxter Pharmaceuticals as Global Medical Director. Carolyn Newberry has research grants from Kenneth Rainin Foundation and American Gastroenterological Association Academy of Educators. Jayshil J. Patel is a consultant for Baxter. Jose M. Pimiento is on the Scientific Medical Board of Advocare. Martin D. Rosenthal is a speaker for Nestlé, Baxter, Abbot, and Fresenius Kabi. Beth Taylor has developed an education program for Baxter Healthcare and is a speaker for Nestle. Osman Mohamed Elfadil, Sara L. Bonnes, Paul J. McCarthy, Reginald Labossiere, Jennifer Katz, Sara A. Hennessy, and Vikram J. Christian have no disclosures to report.
© 2022 American Society for Parenteral and Enteral Nutrition.
- chronic care model
- medical economics
- medical nutrition
- nutrition support
- nutrition support teams
PubMed: MeSH publication types
- Journal Article