Should handgrip strength be considered when choosing the administration mode of oral nutritional supplements in geriatric patients? A secondary analysis of the MEDPass Trial

Katja Uhlmann; Emilie Reber; Katja A Schonenberger; Zeno Stanga; Silvia Kurmann

doi:10.1016/j.nut.2024.112429

Should handgrip strength be considered when choosing the administration mode of oral nutritional supplements in geriatric patients? A secondary analysis of the MEDPass Trial

Nutrition. 2024 Mar 22:124:112429. doi: 10.1016/j.nut.2024.112429. Online ahead of print.

Authors

Katja Uhlmann¹, Emilie Reber², Katja A Schonenberger³, Zeno Stanga², Silvia Kurmann⁴

Affiliations

¹ Health Division, Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland. Electronic address: katja.uhlmann@bfh.ch.
² Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
³ Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland; Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
⁴ Health Division, Nutrition and Dietetics, Bern University of Applied Sciences, Bern, Switzerland.

PMID: 38631270
DOI: 10.1016/j.nut.2024.112429

Abstract

Objective: It is important to individualize nutrition therapy and to identify whether certain patient groups benefit from a specific intervention such as oral nutritional supplements (ONS). This study investigated whether patients with weak handgrip strength (HGS) benefit better from ONS administration in the Medication Pass Nutritional Supplement Program (MEDPass) mode regarding the individual coverage of energy and protein requirements throughout their hospitalization.

Methods: A secondary analysis of the intention-to-treat data set of the randomized controlled MEDPass trial was conducted. Weak HGS was defined as <27 kg for men and <16 kg for women. Linear mixed-effect models adjusted for the stratification factors energy density of ONS and nutritional risk screening 2002 score were used to address the aim of the study.

Results: We included 188 participants. Energy and protein coverage did not differ between the patients with weak or normal HGS depending on ONS administration mode (P = 0.084, P = 0.108). Patients with weak HGS and MEDPass administration mode tended to have the lowest energy and protein coverage (estimated mean, 77.2%; 95% confidence interval [CI], 69.3%-85% and estimated mean, 95.1%; 95% CI, 85.3%-105%, respectively). Patients with weak HGS and conventional ONS administration had the highest energy and protein coverage (estimated mean, 90%; 95% CI, 82.8%-97.2% and estimated mean, 110.2%; 95% CI, 101.3%-119%, respectively).

Conclusion: No clear recommendations regarding the mode of ONS administration depending on HGS can be made. In clinical practice, appetite and satiety in patients with weak HGS should be monitored, and the ONS administration mode should be adjusted accordingly.

Keywords: Energy; Handgrip strength; MEDPass; Malnutrition; Oral nutritional supplements.