Twenty five years of outsourcing home parenteral nutrition: experience of the La Paz University Hospital, Madrid

Introduction: For the last 20 years, most adult patients following home parenteral nutrition (HPN) under the care of the Clinical Nutrition and Dietetics Dept. of the La Paz University Hospital (Unidad de Nutrición Clínica y Dietética del Hospital Universitario La Paz), Madrid, Spain, have received their nutrition formula via a catering system (Nutriservice) responsible for its preparation and home distribution. Aim: To assess the clinical characteristics, quality of life and the degree of satisfaction with the care received received, of patients undergoing HPN who received their nutrition formulae via the named catering service. Materials and Methods: The characteristics of the patients who received HPN via this service between 1992 and 2013 were retrospectively collected. Those patients still undergoing treatment completed a quality of life questionnaire, plus a survey of their satisfaction with the catering system and the care provided by our department. Results: Seventy eight patients were examined; 57.7% were men. The mean age of the patients was 53.1±14.3 years. The most common underlying disease was cancer, both in advanced stage (33.8% of all cases) and in stages in which active treatment was being provided (34%). The most common indication for HPN was intestinal obstruction (46%). The median duration of HPN treatment was 96 [1-5334] days. The most common complication was catheter infection (72%). For the analysis of the results, the patients were divided depending on disease type: those with advanced stage cancer, those with cancer under active treatment and with a better prognosis, and those with non-oncological disease. The patients undergoing active oncological treatment believed the quality of their lives to have been improved by the Nutriservice catering system, and rated the care received by our department positively. Conclusions: In our experience, patients with cancer are those who most commonly receive HPN, especially those with advanced disease. Given the seriousness of their conditions, and the complexity surrounding the use of HPN, catering systems appear to offer a means of improving their quality of life.

Saved in:
Bibliographic Details
Main Authors: Gómez-Candela,Carmen, Martín Fuentes,María, García Vázquez,Natalia, Crespo Yanguas,Marta, Lisbona Catalán,Arturo, Campos del Portillo,Rocío, Palma Milla,Samara
Format: Digital revista
Language:English
Published: Grupo Arán 2014
Online Access:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112014001300014
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction: For the last 20 years, most adult patients following home parenteral nutrition (HPN) under the care of the Clinical Nutrition and Dietetics Dept. of the La Paz University Hospital (Unidad de Nutrición Clínica y Dietética del Hospital Universitario La Paz), Madrid, Spain, have received their nutrition formula via a catering system (Nutriservice) responsible for its preparation and home distribution. Aim: To assess the clinical characteristics, quality of life and the degree of satisfaction with the care received received, of patients undergoing HPN who received their nutrition formulae via the named catering service. Materials and Methods: The characteristics of the patients who received HPN via this service between 1992 and 2013 were retrospectively collected. Those patients still undergoing treatment completed a quality of life questionnaire, plus a survey of their satisfaction with the catering system and the care provided by our department. Results: Seventy eight patients were examined; 57.7% were men. The mean age of the patients was 53.1±14.3 years. The most common underlying disease was cancer, both in advanced stage (33.8% of all cases) and in stages in which active treatment was being provided (34%). The most common indication for HPN was intestinal obstruction (46%). The median duration of HPN treatment was 96 [1-5334] days. The most common complication was catheter infection (72%). For the analysis of the results, the patients were divided depending on disease type: those with advanced stage cancer, those with cancer under active treatment and with a better prognosis, and those with non-oncological disease. The patients undergoing active oncological treatment believed the quality of their lives to have been improved by the Nutriservice catering system, and rated the care received by our department positively. Conclusions: In our experience, patients with cancer are those who most commonly receive HPN, especially those with advanced disease. Given the seriousness of their conditions, and the complexity surrounding the use of HPN, catering systems appear to offer a means of improving their quality of life.