Clinical and economic effects of managing malnutrition

With the considerable cost of disease-related malnutrition to individuals and to society, there is a need for effective, evidence-based ways of preventing and treating this condition. Oral nutritional supplements (ONS) are an evidence based way of managing malnutrition. Systematic reviews and meta-analyses consistently suggest that the use of liquid, multi-nutrient oral supplements in the management of malnutrition can improve total nutritional intakes and body weight compared to routine care. Meta-analyses also suggest that ONS can significantly reduce complications (e.g. infections, pressure ulcers), mortality and hospital admissions in some patient groups. Such benefits suggest that the appropriate use of ONS should form an integral part of the management of malnutrition, together with approaches to maximise dietary intakes where feasible. As with all therapies, compliance to ONS needs to be maximised and the use monitored. To make sure that those at risk of malnutrition are identified and treated appropriately there is a need to implement policies that incorporate screening and care plans for the prompt management of malnutrition into routine clinical practice. In doing so, the economic burden of this costly condition can be curtailed. As recently suggested by the National Institute for Health and Clinical Excellence (NICE) in the UK, substantial cost savings could occur if screening and treatment of malnourished patients was undertaken. (Nutr Hosp Supl. 2012;5(1):87-95)