À qui et comment prescrire des compléments nutritionnels oraux à l’hôpital et à domicile ? | To whom and how to prescribe oral nutritional supplements in hospital and in community?
2013
Pradignac, Alain | Kazma, Carim | Ilic, Jelena
Oral nutritional supplements (ONS) are a simple mean to increase the nutritional intake of undernourished people. Although generally well tolerated, the compliance to these dietetic products can be poor and then contribute to reduce their clinical efficacy. It may be improved by determining reasonable nutritional goals, which must be explained to the patient, and by observing rigorous conditions of prescription and administration of ONS. ONS have shown positive results in reducing both morbidity and mortality in poly-pathological elderly people, either in hospital or in community. Such positive clinical data were also reported in orthopedic surgery, in hip fractures, in preparative period of gastrointestinal surgery or in patients treated with hemodialysis. Their efficacy was less obvious in patients with chronic respiratory failure or cancer. ONS are able to prevent pressure sores in high risk patients. However, studies evaluating ONS efficacy on pressure sores healing are lacking and of poor quality. Finally, ONS have demonstrated no beneficial clinical effect on cognitive function in patients with Alzheimer's disease or on functional recovery of well-nourished people with stroke.
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