MEDPass Trial Examination of an innovative administration mode of oral nutritional supplements

Situation

Patients at nutritional risk are often dependent on oral nutritional supplements (ONS) to cover their energy and protein requirements. Compliance with ONS is often low which poses a barriere to adequate oral nutrition therapy. There are no standards on ONS administration in terms of timing throughout the day. This leads to unsystematic approaches. Conventionally, ONS are served as snacks between the main meals. The so called MEDPass administraion mode offers a new approach. Administration in the MEDPass mode means a distribution of ONS together with medication rounds three to four times a day in unusually small amounts.

Goals

The MEDPass Trial investigated if:

• energy and protein intake of medical and geriatric inpatients is enhanced by MEDPass administration of ONS
• handgrip strength as a sensitive parameter for protein-energy malnutrition may be optimized by MEDPass administration of ONS
• there are differences in the course of weight, nausea and appetite
• length of hospital of stay (LOS) and 30-day mortality differs between the groups

Course of action

From November 2018 to November 2021, patients were recruited from medical and geriatric wards of Inselspital, Bern University Hospital, facility Tiefenau

• randomized controlled study design 
• malnutrition risk screening
• continuous monitoring of ONS and food intake
• calculation of energy and protein intakes including blinded validation
• weekly study visits to assess HGS, weight, appetite, and nausea
• evaluation of LOS and 30-day mortality

Adjacent Bachelor- and Mastertheses

Bachelor

• • Bachelorthesis: Wie stehen Pflegefachpersonen zu unterschiedlichen Verabreichungsformen von Trinknahrung? (German)
• MEDPass vs. herkömmliche Verabreichung von Trinknahrung: Die Einstellung von Pflegefachpersonen zu den beiden Verabreichungsmodi (German) (in process for publication)
• Wie erleben Patientinnen und Patienten die Verabreichung und Einnahme von ONS im MEDPass-Modus versus im herkömmlichen Modus? (German)
• Etablierung des MEDPass-Verabreichungsmodus oraler Nahrungssupplemente. Vom Entscheid bis zur Nachbetreuung (German) (in process for publication)

Master

• MEDPass Trial – Secondary Analysis of Data for NRS 2002 Scores and Energy Content of Oral Nutritional Supplements (in process for publication)
• Handgrip Strength and Coverage of Energy and Protein Requirements - What Is the Relationship? A Secondary Analysis of the MEDPass Trial (in process for publication)