MO003ADHERENCE TO DIETARY GUIDELINES IN ADULTS UNDERGOING MAINTAINANCE HAEMODIALYSIS: THE DIET-HD STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Valeria Saglimbene ◽  
Guobin Su ◽  
Marinella Ruospo ◽  
Juan Jesus Carrero ◽  
Giovanni Strippoli
Keyword(s):  
Best Practice ◽  
Dietary Guidelines ◽  
Dietary Intakes ◽  
Cross Sectional ◽  
Best Practice Guidelines ◽  
Adherence To Diet ◽  
Nutritional Recommendations ◽  
Dietary Guideline ◽  
Sectional Analysis

Abstract Background and Aims While clinical guidelines emphasize dietary modifications as a cornerstone component in the management of patients undergoing dialysis, the adherence to these recommendations has been poorly quantified. The aim of this study is to evaluate the extent of adherence to diet guidelines for adults treated with long-term haemodialysis within the European patients included in the multinational cohort of the “DIETary intake, death and hospitalization in adult with ESKD treated with Haemodialysis” (DIET-HD) study. Method Cross-sectional analysis of the DIET-HD study in 6906 adults undergoing haemodialysis in 10 European countries. Patients responded to the Global Allergy and Asthma European Network (GA2LEN) Food Frequency Questionnaire, and dietary intakes were estimated to evaluate the adherence to the European Best Practice Guidelines nutritional recommendations. Results Patients showed low adherence to the daily recommended intake of phosphorous (<1000mg, met by 25% of participants) and potassium (<2730mg, met by 28% of participants). Almost half the participants achieved targets for energy (>30 kcal/kg, 45% of participants) and calcium (<800mg/day, 53% of participants) intake, while the recommended sodium (<2300mg/day) and proteins intake (≥1.1g/kg) was achieved in 85% and 67% of participants, respectively. Adherence to renal guidelines varied across participating countries, but followed the same pattern. Only 1% of patients adhered to all six recommendations at the same time. Conclusion Adherence to dietary guideline recommendations is poor, particularly regarding phosphorus, potassium, calcium and energy intake.

scholarly journals Dietary intake in adults on hemodialysis compared with guideline recommendations

2021 ◽  
Author(s):  
Valeria M. Saglimbene ◽  
Guobin Su ◽  
Germaine Wong ◽  
Patrizia Natale ◽  
Marinella Ruospo ◽  
...  
Keyword(s):  
Dietary Intake ◽  
Practice Guidelines ◽  
Best Practice ◽  
Daily Intake ◽  
Dietary Intakes ◽  
Cross Sectional ◽  
Maintenance Haemodialysis ◽  
Best Practice Guidelines ◽  
Balanced Diet ◽  
Sectional Analysis

Abstract Background Clinical practice guidelines of dietary management are designed to promote a balanced diet and maintain health in patients undergoing haemodialysis but they may not reflect patients’ preferences. We aimed to investigate the consistency between the dietary intake of patients on maintenance haemodialysis and guideline recommendations. Methods Cross-sectional analysis of the DIET-HD study, which included 6,906 adults undergoing haemodialysis in 10 European countries. Dietary intake was determined using the Global Allergy and Asthma European Network (GA2LEN) Food Frequency Questionnaire (FFQ), and compared with the European Best Practice Guidelines. Consistency with guidelines was defined as achieving the minimum daily recommended intake for energy (≥ 30 kcal/kg) and protein (≥ 1.1 g/kg), and not exceeding the maximum recommended daily intake for phosphate (≤ 1000 mg), potassium (≤ 2730 mg), sodium (≤ 2300 mg) and calcium (≤ 800 mg). Results Overall, patients’ dietary intakes of phosphate and potassium were infrequently consistent with guidelines (consistent in 25% and 25% of patients, respectively). Almost half of the patients reported that energy (45%) and calcium intake (53%) was consistent with the guidelines, while the recommended intake of sodium and protein was consistent in 85% and 67% of patients, respectively. Results were similar across all participating countries. Intake was consistent with all six guideline recommendations in only 1% of patients. Conclusion Patients on maintenance haemodialysis usually have a dietary intake which is inconsistent with current recommendations, especially for phosphate and potassium.

scholarly journals Disparities in telephone and video telehealth engagement during the COVID-19 pandemic

JAMIA Open ◽  
2021 ◽  
Vol 4 (3) ◽  
Author(s):  
Jonathan W Sachs ◽  
Peter Graven ◽  
Jeffrey A Gold ◽  
Steven Z Kassakian
Keyword(s):  
Best Practice ◽  
English Language ◽  
Structural Barriers ◽  
Cross Sectional ◽  
Care Access ◽  
Best Practice Guidelines ◽  
Black Patients ◽  
Ambulatory Patients ◽  
Demographic Representation ◽  
Sectional Analysis

Abstract Objective The COVID-19 pandemic and subsequent expansion of telehealth may be exacerbating inequities in ambulatory care access due to institutional and structural barriers. We conduct a repeat cross-sectional analysis of ambulatory patients to evaluate for demographic disparities in the utilization of telehealth modalities. Materials and Methods The ambulatory patient population at Oregon Health & Science University (Portland, OR, USA) is examined from June 1 through September 30, in 2019 (reference period) and in 2020 (study period). We first assess for changes in demographic representation and then evaluate for disparities in the utilization of telephone and video care modalities using logistic regression. Results Between the 2019 and 2020 periods, patient video utilization increased from 0.2% to 31%, and telephone use increased from 2.5% to 25%. There was also a small but significant decline in the representation males, Asians, Medicaid, Medicare, and non-English speaking patients. Amongst telehealth users, adjusted odds of video participation were significantly lower for those who were Black, American Indian, male, prefer a non-English language, have Medicaid or Medicare, or older. Discussion A large portion of ambulatory patients shifted to telehealth modalities during the pandemic. Seniors, non-English speakers, and Black patients were more reliant on telephone than video for care. The differences in telehealth adoption by vulnerable populations demonstrate the tendency toward disparities that can occur in the expansion of telehealth and suggest structural biases. Conclusion Organizations should actively monitor the utilization of telehealth modalities and develop best-practice guidelines in order to mitigate the exacerbation of inequities.

Opioid crisis in primary care? An audit of high-dose opioid prescribing at Bangholm GP Practice

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711581
Author(s):  
Charlotte Greene ◽  
Alice Pearson
Keyword(s):  
Chronic Pain ◽  
Back Pain ◽  
Practice Guidelines ◽  
Best Practice ◽  
Evidence Base ◽  
High Dose ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Best Practice Guidelines

BackgroundOpioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018.AimAn audit at Bangholm GP Practice to understand the scale of high-strength opioid prescribing. The aim of the audit was to find out if indications, length of prescription, discussion, and documentation at initial consultation and review process were consistent with best-practice guidelines.MethodA search on Scottish Therapeutics Utility for patients prescribed an average daily dose of opioid equivalent ≥50 mg morphine between 1 July 2019 and 1 October 2019, excluding methadone, cancer pain, or palliative prescriptions. The Faculty of Pain Medicine’s best-practice guidelines were used.ResultsDemographics: 60 patients (37 females), average age 62, 28% registered with repeat opioid prescription, 38% comorbid depression. Length of prescription: average 6 years, 57% >5 years, 22% >10 years. Opioid: 52% tramadol, 23% on two opioids. Indications: back pain (42%), osteoarthritis (12%), fibromyalgia (10%). Initial consultation: 7% agreed outcomes, 35% follow-up documented. Review: 56% 4-week, 70% past year.ConclusionOpioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.

scholarly journals Dairy Product Intake and Long-Term Risk for Frailty among French Elderly Community Dwellers

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2151
Author(s):  
Berna Rahi ◽  
Hermine Pellay ◽  
Virginie Chuy ◽  
Catherine Helmer ◽  
Cecilia Samieri ◽  
...  
Keyword(s):  
Older Adults ◽  
Dairy Product ◽  
Food Group ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Sectional Analysis ◽  
Community Dwelling Older Adults

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.

Dietary Intakes and Nutritional Status Among Migrant Children in Primary Schools: A Cross-Sectional Study

2020 ◽  
Author(s):  
Jing Zeng ◽  
Lijing Shao ◽  
Yongjun Li ◽  
Mei Yang ◽  
Bing Xiang ◽  
...  
Keyword(s):  
Nutritional Status ◽  
Dietary Pattern ◽  
Primary Schools ◽  
Energy Requirement ◽  
Dietary Guidelines ◽  
Migrant Children ◽  
Nutrition Intervention ◽  
School Age Children ◽  
Dietary Intakes ◽  
Cross Sectional

Abstract Background: Nutrition plays a crucial role in children’s growth and development, migrant children have their own characteristics in nutrition. The current study aims to assess the dietary status of migrant school-age children and underlying factors. Methods: A cross-sectional survey was carried out on migrant children in 25 classes with the 3rd to 6th grades from two primary schools by cluster sampling. Children’s 3-day 24-hour diet were recorded, the dietary intake of calories and nutrients were calculated by using the China Food Composition for each day, and were presented the average intake of the 3 day period. The assessment of energy and nutrient intakes by estimated energy requirement (EER) and estimated average requirement (EAR), respectively. The Dietary Guidelines for Chinese Residents and Chinese Dietary Reference Intakes were used as evaluation standards to assess the dietary intakes and nutritional status of these children.Results: Participants included 752 migrant children aged 9-12y (430 boys and 322 girls). Deficiency proportions of energy and protein were 46.1% and 40.1% for boys, 44.4% and 65.1% for girls. Energy supply proportions of macronutrients (protein, fat, and carbohydrate) in boys were 12.4%、28.8%、58.8%, those of girls were 11.1%、28.6%、60.3%. The insufficiency proportions of vitamin A, B vitamins, calcium, zinc and selenium were considerably serious (>60%). In dietary pattern, intakes of cereal, poultry and edible oil were relatively adequate, but milk, fish, eggs and soybean products were seriously inadequate. Conclusions: Characteristics such as unreasonable dietary pattern, relative lack of energy and nutrients, and excess snack intake coexist, it is necessary to carry out nutrition intervention to help migrant children to balance the diet and rectify the deficiencies.

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