Aim
The use of a “Supplements As Medicine” (SAM) or Medication Pass Nutrition Supplement Program (MEDPASS) program can be impactful if implemented effectively and tailored to the local context. A gap between evidence and practice was clearly identified as a local audit found that only 23% of patients with charted SAM were consuming the prescribed dose. Assessing the barriers to patient intake of SAM and addressing the identified problems has the potential to not only improve the nutritional status of our vulnerable patient population but also reduce cost to the HHS through a reduction in wastage.
Benefits
Outcome evaluation will be conducted by completing medication audits (similar to the audit to assess the problem). This will include patient consumption, nursing provision, medication chart signing and escalation if not consumed.
Background
Patients with disease-related malnutrition may have nutrition impact symptoms including poor appetite and early satiety. A literature review found that nutritional supplements contribute towards beneficial clinical outcomes for malnourished patients. Evidence is stronger to support the use of oral nutrition supplements in specific patient groups including the acutely ill elderly and hip fracture patients. Literature surrounding the use of SAM or MEDPASS indicate this method of nutrition provision can be utilised effectively. This is supported by the malnutrition chapter of Queensland Health's Framework for Effective and Efficient Dietetic Services (FEEDS). SAM is used frequently for patients within Geriatric Evaluation and Management (GEM) as there is a high prevalence of geriatric patients who have an extended length of stay in hospital and require increased nutritional requirements for a variety of comorbidities.
