LB037 - IMPLEMENTATION OF NUTRITIONAL ASSESSMENT IN ROUTINE DIETETIC CARE: PRELIMINARY RESULTS OF A NATIONAL SURVEY

LB037

IMPLEMENTATION OF NUTRITIONAL ASSESSMENT IN ROUTINE DIETETIC CARE: PRELIMINARY RESULTS OF A NATIONAL SURVEY

S. Rademaker^1,*, M. van den Berg¹, I. van Vliet², G. Dolleman³, D. Gort-van Dijk⁴, R. Greene⁵, M. Kienhuis⁶, N. Linthorst⁴, M. de van der Schueren^7,8, W. Visser⁹, B. Welink-Lamberts⁴, E. Wopereis⁹, H. Zweers-van Essen¹, C. Prado¹⁰, M. Sealy^1,11, H. Jager-Wittenaar^1,11 on behalf of OPTIMISE consortium

¹Gastroenterology and Hepatology - Dietetics, Radboudumc, Nijmegen, ²Dietetics, UMCG, Groningen, ³Physiotherapy, ⁴Dietetics, Isala, Zwolle, ⁵Patient Inclusive Advocacy Foundation, Amsterdam, ⁶Diëtisten Groep NL, Dedemsvaart, ⁷Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, ⁸Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, ⁹Dietetics, Erasmus MC, Rotterdam, Netherlands, ¹⁰Faculty of Agricultural, Life and Environmental Science- Agricultural, Food & Nutrition Science Department, University of Alberta, Alberta, Canada, ¹¹Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze, Groningen, Netherlands

Rationale: We aimed to evaluate implementation status of nutritional assessment (NA), including body composition and physical function, in Dutch dietetic practice, across healthcare settings. 

Methods: An online survey was conducted among Dutch dietitians to assess NA use and methods, utilization in dietary treatment, implementation barriers for NA, and rate self-perceived competence in 9 NA-related tasks (score 0-lowest to 10-highest). Differences between settings (1st, 2nd, 3rd line care) were tested using Fisher's exact tests, with Bonferroni post-hoc analysis (significance p<0.05). 

Results: Data of 158 dietitians (25%, 47%, 30% working in 1st, 2nd, and 3rd line) were analyzed. Overall, 38% applied NA in ≥50%, and 58% in <50% of their patients (4% unknown). Implementation rate in 2nd line (26%) was lower than in 1st (54%) and 3rd line (49%) (p=0.024). Main reasons to perform NA were diagnosing malnutrition (78%), monitoring body composition (77%), and patient motivation (68%). Median self-perceived competence ranged from 6 [IQR 5–7] (interpreting physical function) to 9 [IQR 8–9] (interpreting dietary intake). Bioelectrical impedance analysis (BIA) was mostly used for body composition (79%, 82%, 98% in 1st, 2nd, and 3rd line; p=0.022). Handgrip strength was mostly used for physical function (52%, 53%, and 80% in 1st, 2nd, and 3rd line; p=0.014). Key implementation barriers were lack of time (76%) and limited access to instruments (36%). More personalized dietetic treatment (84%) and better diagnostics (70%) were most reported positive effects of NA. 

Conclusion: Implementation of NA is highest in 1st and 3rd line care. Over one-third applies NA in at least half of their patients, mostly using BIA and/or handgrip strength. Generally, Dutch dietitians feel competent to perform NA. Dietitians indicate NA implementation can be improved by creating more time and better access to assessment instruments.  

Disclosure of Interest: None declared