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JFSF Vol 9, No 2, June 2024, p.131-141

doi: 10.22540/JFSF-09-131

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Original Article

Nutritional Screening, Initial Management and Referral for Older People with Sarcopenia or Frailty - Results from a UK-Wide Survey

Caroline Bowler1, Elizabeth Moriarty1, Melody Chawner2, Andrew Clegg3, Sarah De Biase4, Natalie Offord5, Vittoria Romano6, Avan A. Sayer7,8, Alison Smith6,9, Oliver Todd3, Miles D. Witham7,8

  1. Chesterfield Royal Hospital, Chesterfield Road, Callow, Chesterfield, UK
  2. Solent NHS Trust, Portsmouth, UK
  3. Academic Unit for Ageing and Stroke Research, University of Leeds, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
  4. AGILE, Professional Network for Physiotherapists Working with Older People and West Yorkshire Integrated Care Board, Longterm Conditions and Personalisation, White Rose House, Wakefield, UK
  5. Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
  6. British Dietetic Association Older People’s Specialist Group, Central London Community Health Care Trust, London, UK
  7. AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
  8. NIHR Newcastle Biomedical Research Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and Newcastle University, Newcastle, UK
  9. Hertfordshire and West Essex Integrated Care Board, Hemel Hempstead, UK

Keywords: Frailty, Nutrition, Older People, Sarcopenia, Survey


Abstract

Objectives: We surveyed healthcare staff working with older people to understand current practice in nutrition screening, initial management and referral for older people with sarcopenia and frailty. Methods: We conducted a UK-wide web-based survey of staff working with older people in both hospital and community settings. Surveys were distributed through professional organisation e-mail lists and social media channels. Descriptive data were generated from categorical responses and inductive thematic analysis was applied to free-text responses. Results: Data were analysed from 169 respondents (110 hospital, 59 community), representing 99 healthcare organisations. 91 (83%) hospital respondents and 24 (41%) community respondents reported that nutrition screening was performed on all patients with sarcopenia or frailty. The Malnutrition Universal Screening Tool was most commonly used to trigger referral to dietetics teams, but there was considerable variation in management before referral, referral thresholds and referral pathways. Themes derived from free-text responses included the need for training, issues of responsibility and ownership, inadequate resources (time, staff and equipment) and ineffective or inefficient processes for referral and management. Conclusions: Current UK nutritional care for older people with sarcopenia and frailty is heterogeneous. There are opportunities for better tools, processes, training and resources to improve current practice and pathways.
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