P458 - THE OLIVE TREE: AN ELECTRONIC TOOL TO SUPPORT INITIATION OF PARENTERAL NUTRITION IN ADULT HOSPITALIZED PATIENTS

P458

THE OLIVE TREE: AN ELECTRONIC TOOL TO SUPPORT INITIATION OF PARENTERAL NUTRITION IN ADULT HOSPITALIZED PATIENTS

B. Deleenheer^1,2,3,*, L. Defieuw³, P. Declercq³, T. Vanuytsel^1,2

¹Translational Research Centre for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism (ChroMetA), KU Leuven, ²Leuven Intestinal Failure and Transplantation Centre (LIFT), ³Hospital Pharmacy Division, University Hospitals Leuven, Leuven, Belgium

Rationale: Parenteral nutrition (PN) is necessary to overcome malnutrition in hospitalized patients with acute or chronic intestinal failure, but is associated with complications. Physicians often lack knowledge in clinical nutrition, which makes clinical decision support tools recommended for prescribing PN. This study evaluated the impact of the OLIVE TREE, a decision tree integrated into the prescribing software at University Hospital Leuven, Belgium, on prescribing behavior and safety.¹

Methods: Two cohorts were compared: 63 patients who received OLIVE TREE-guided PN initiation and 63 who did not. The primary outcome, assessed in the first cohort, was the proportion of patients for whom the OLIVE TREE impacted prescribing behavior. Secondary outcomes included changes in initial PN regimens, time to regimen change, mortality and PN-related complications (hyperglycemia, liver dysfunction, fluid overload, catheter-related thrombosis, central line associated bloodstream infection and PN-related intensive care transfer).

Results: An impact on prescribing behavior was observed in 33 of 63 patients (52.4%; 95% CI 39.4-65.1; p < 0.001), resulting in providing more calories (27.0%), less calories (9.5%) and more refeeding protocols (6.3%). Initial PN regimens were altered in 54.0% of both cohorts, with a median time to change of six days (p = 0.820). No significant differences were found in mortality (1.6% and 3.2%; p = 0.747) or complications (31.9% and 48.1%; p = 0.284) between the OLIVE TREE and non-OLIVE TREE cohort.

Conclusion: The OLIVE TREE significantly impacted prescribing behavior, without leading to earlier or more frequent PN regimen changes or increased complications.

References: 1 Van den Broucke E et al. Offering Guidance and Learning to Prescribers to Initiate Parenteral Nutrition using a Validated Electronic Decision TREE (OLIVE TREE). J Med Syst. 2022;46(8):56.

Disclosure of Interest: None declared