Presse Nancy, Université de Sherbrooke, Centre de recherche sur le vieillissement, Professeur-chercheur, Canada,
Meeting dietary needs of long-term care residents, particularly those with dementia, is a daily challenge. To improve intakes, oral nutritional supplements (ONS) are often offered. However, ONS may not always be offered or consumed as prescribed. The Nutrition as Medication (NAM) program prescribes small doses (30-60mL) of ONS offered with the medication passes 1 to 4 times a day, instead of being offered with meals or as snacks. The ONS doses provide 2kcal/mL and are registered in the medication chart. This controlled pilot trial aimed to evaluate the potential of the NAM program in preventing weight loss and pressure sores among residents requiring ONS. This 6-month trial was conducted within two 75-bed long-term care units. One unit pursued usual care, meaning that residents requiring ONS received them with meals or as snacks according to the dietitian prescription. The other unit implemented the NAM program. Adherence to ONS prescriptions, body weight (measured monthly) and pressure sores were monitored. In total, 20 residents had their ONS prescription converted to the NAM program. Control group included 28 residents receiving ONS as per usual. Mean body mass index (BMI) at baseline was 22.7±4.5kg/m2, with 30% having BMI<20kg/m2. Over the 6-month period, adherence to the NAM prescriptions was 93%, compared to 67% in the control group. Overall, 10% of residents within the NAM program presented with weight loss ?1.5kg over the 6-month period, compared to 46% in the control group. Similarly, 10% of residents within the NAM program suffered from ?1 pressure sores, while this proportion was 27% in the control group. This pilot trial resulted in startling effects despite the small sample size. Registering ONS prescriptions in the medication chart might be the key component of the program efficacy, as adherence to ONS prescriptions was markedly higher in the NAM program.