The Design of the Feeding Support Trial - does intensive feeding support improved nutritional status and outcome in acutely ill older in-patients?

Introduction: Malnutrition has been estimated to cast the NHS pound 266 mil lion a year because malnourished patients have longer hospital stays and in creased morbidity. Malnutrition is particularly common in the elderly. Most attempts to reverse malnutrition in this group have used liquid supplement s but the results have been disappointing; even under surveillance, ill ald er patients often do not take enough supplements to improve their nutrition al status. In routine clinical practice the situation is worse because poor nutrition is often not recognized and compliance with supplements is low A nother approach is needed. Objective: To describe the protocol of The Feeding Support Trial which aims to examine whether health care assistants, trained to provide support with all aspects of feeding, can make a significant impact on nutritional intak e and whether this improves outcome. Design: A randomized control trial designed to determine whether feeding su pport increases nutritional intake leads to measurable changes in nutrition al status (body mass index, arm circumference, serum albumin) and leads to improved outcome (infection rate, Barthel scare, length of stay and readmis sion rate). Setting: Three elderly medicine wards at Hammersmith Hospitals NHS Trust. T he study commenced in June 1998. Subjects: The trial aims to recruit 1500 subjects (750 in each group).