nDay in Primary Care settings
For the first time in 2023 nutritionDay launches nDay in Primary Care, the international audit on nutritional care conducted in Primary Health care centers.
The nDay audit aims raise awareness for disease related malnutrition in the Primary Care settings and to offer possibility of benchmarking and monitor the quality of the nutritional care offered in this setting.
Prevalence of malnutrition in primary care setting
In the context of Primary Healthcare, prevalence of malnutrition and its related risk factors is not clear, and it is supposed to be largely underestimated, both due to the lack of organized screening as well as because of the lack of awareness of health professionals regarding disease related malnutrition and its association to poor outcomes.
Since 2006, the nutritionDay project has investigated the prevalence of the nutrition related risk factors in hospitalized patients worldwide demonstrating that each of the nutrition related risk factors is associated with an increase mortality within 30 days in hospital (7).
Malnutrition is the result of unintentional weight loss, low food intake and inflammation (1).Weight loss and reduced nutrient intake are found in nearly half of the hospitalized patients participating in the nutritionDay audit whereas apparent malnutrition with body mass index BMI<18.5 is only present in less than 10% of the patients. The nutrition related risk factors have been found by the nutritionDay study to be similarly prevalent worldwide.
Malnutrition in Primary Care setting is still understudied and it is thought to be largely underdiagnosed.
What is the situation of patients before hospitalization?
Most of the malnutrition risk factors are already present at hospital admission and thus are developing in the community before hospitalization.
Whereas in hospital, malnutrition screening and assessment are recommended by guidelines and are mandatory at admission in certain countries, no such recommendations exists for the primary care setting.
In the context of Primary Healthcare, prevalence of malnutrition and its related factors is not clear, but it is supposed to be largely underestimated, both due to the lack of organized screening and the lack of awareness of health professionals regarding this problem.
Malnutrition has been reported to be in association with hospitalization and diseases-related malnutrition. Many analyses of risk factors suggest that malnutrition develops progressively before hospitalization. Malnutrition in Primary Health Care has been not been systematically studied and it is thought to be largely underdiagnosed thus early treatment may not be given.
nDay in Primary care pilot in 2022
The nutritionDay questionnaires for Primary Care setting have been developped to evaluate the nutritional status and nutrition care of patients who resort to Primary Health Care on nutritionDay.
The aim is to determine the prevalence of individual malnutrition related risk factors and of the use of nutrition therapy in the Primary care context and their association with patient outcome after six months.
In 2022, for the first time, a pilot audit has been carried out in Primary Health Care Centers and individual primary care offices, with the possibility to audit non-hospitalized patients.The questionnaire to be applied was the same in all adherent countries (translated into the language of the country). Among countries participating in the pilot study there are PORTUGAL, GERMANY, CROATIA, SLOVENIA and AUSTRIA which carried out this screening in Primary Health Care Centers for the first time. The development of Primary Care questionnaires was carried out by the nutritionDay team at the Medical University of Vienna together with several PEN societies such as the portuguese Associação Portuguesa de Nutrição Entérica e Parentérica (APNEP), the Slovenian Society for Clinical Nutrition (SZKP), the Austrian Society for Clinical Nutrition (AKE), the Croatian Society of Clinical Nutrition Croatian Medical Association (CSPEN), the German Nutrition Society (DGEM) with the overall support from the members of the European Society for Clinical Nutrition and Metabolism (ESPEN).
The audit will increase knowledge and interest for disease related malnutrition and nutritional care in the Primary Care setting.
In 2023 the nDay audit enlarges to welcome all worldwide countries to participate on NOV 9th 2023 with questionnaires translated in several languages.