Effectiveness and efficacy of nutritional therapy
Citation: Muscaritoli M., Krznarić Z., Singer P., et al. Effectiveness and efficacy of nutritional therapy: A systematic review following Cochrane methodology. Clinical Nutrition, 2017;36(4):939-57
Freely available: No
The result of this review supports the use of nutritional therapy to reduce healthcare costs, most evident from large, homogeneous studies. In general, reports are too heterogeneous and overall of limited quality for conclusions on impact of malnutrition and its treatment on readmissions.
Disease related malnutrition can have a damaging effect on patient outcomes and health costs. This review aimed to answer four questions;
- Is malnutrition an independent predictive factor for readmission within 30 days from hospital discharge?
- Does nutritional therapy reduce the risk of readmission within 30 days from hospital discharge?
- Is nutritional therapy cost-effective/does it reduce costs in hospitalized patients?
- Is nutritional therapy cost effective/ does it reduce costs in outpatients?
Literature (including meta-analyses and randomized control trials) was assessed for bias using a modified Cochrane Risk of Bias tool. The results found six out of fifteen trials reported malnutrition as predictive of hospital readmissions. No conclusive results were found for the extent to which hospital readmissions may be reduced by nutritional therapy. The economic benefit and cost effectiveness of treating malnutrition in hospitals was consistent across sixteen trials. In selected sub-groups of outpatients, it was noted there may be cost benefits to nutritional therapy.
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