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Nutritional advice and treatment by dietitians to patients with amyotrophic lateral sclerosis/motor neurone disease: a survey of current practice in England, Wales, Northern Ireland and Canada.

https://arctichealth.org/en/permalink/ahliterature165524
Source
J Hum Nutr Diet. 2007 Feb;20(1):3-13
Publication Type
Article
Date
Feb-2007
Author
A. Rio
E. Cawadias
Author Affiliation
King's MND Care and Research Centre, King's College Hospital, London, UK. alan.rio@kingsch.nhs.uk
Source
J Hum Nutr Diet. 2007 Feb;20(1):3-13
Date
Feb-2007
Language
English
Publication Type
Article
Keywords
Amyotrophic Lateral Sclerosis - therapy
Canada
Dietetics - standards
England
Evidence-Based Medicine
Health Knowledge, Attitudes, Practice
Humans
Interdisciplinary Communication
Ireland
Nutrition Assessment
Nutritional Requirements
Nutritional Support - standards
Patient care team
Questionnaires
Wales
Abstract
The management of amyotrophic lateral sclerosis/motor neurone disease (ALS/MND) has shifted from an attitude of nihilism to treatments that prolong survival and offer hope. Nutrition is an integral component of ALS/MND care requiring coordination among acute and community multi-disciplinary teams (MDT). Evidence-based nutrition guidelines exist for this patient group but their use among dietitians is unknown. The aim of this study was to survey the knowledge, practice and guideline use of dietitians working in ALS/MND centres/clinics across England, Wales, Northern Ireland (EWNI) and Canada.
Dietetic contact details were obtained from the Motor Neurone Disease Association (MNDA) and the ALS Society of Canada (ALSSC) websites. Telephone interviews were conducted with 23 dietitians using a standardized questionnaire.
Multi-disciplinary team membership was high (78%). Only 22% dietitians had >4-years experience in ALS/MND care. Dietitians reported using body weight, percentage weight loss (PWL) and body mass index (BMI) to assess nutritional status. Equations used to estimate energy and protein requirements differed. Most frequent dietary advice was high calorie, texture modification and prescription nutritional supplements. Artificial nutrition and hydration (ANH) was discussed when patients developed dysphagia, energy intake was inadequate, weight loss of 10% or forced vital capacity (FVC) was reduced. A percutaneous endoscopic gastrostomy (PEG) service was available at all clinics/centres.
Nutritional assessment techniques and dietary advice should be standardized. Dietetic collaboration at national and international level is recommended to reduce professional isolation. Training and support in ALS/MND nutrition should be made available as part of post-dietetic registration. Further dietetic research is required to stimulate nutritional care.
PubMed ID
17241187 View in PubMed
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