In an interview with PharmaShots, Suela Sulo, Ph.D., M.S., Director of Global Health Economics, Outcomes Research and Policy at Abbott shared her views on how this study will shift the way to approach nutrition across the continuum of care.

Shots:

• A study published in the Journal of Primary Care and Community Health has shown that a new simple model of care where HCPs screen for malnutrition risk, quickly institute a nutrition care plan that includes an appropriate oral nutritional supplement, and educate on the importance of continuing healthy nutrition habits at home over 90-days can help improve care, reduce health resource use, and lower healthcare costs
• This model can also be successfully recreated in a range of settings, from hospitals and outpatient clinics, to skilled nursing facilities and home healthcare
• The MST is a validated tool that helps to screen, identify and treat people who are at risk for malnutrition

Tuba: Share the details of this model of care with our readers. How it can shift the way to approach nutrition across the continuum of care?

Suela Sulo: The Quality Improvement Program (QIP) is a comprehensive and multi-dimensional model with three key steps:

• Screen Patients to Determine Malnutrition Risk: Screen and assess patients for undernutrition or overnutrition risk with a few simple questions.
• Communicate a Personalized Nutrition Care Plan: Create a customized plan and recommend an appropriate nutritional drink such as Ensure or Glucerna to help patients get the nutrients they need.
• Deliver Nutrition Education: Educate patients and their caregivers on the importance of nutrition and nutritional drinks compliance.

Nutrition tends to be healthcare's blind spot. QIPs highlight the importance of recognizing and treating malnutrition as a vital sign; blood pressure monitoring, for example. It takes only a few minutes to recognize if someone is at nutritional risk and within minutes nutrition care plans can be created to ensure at-risk or malnourished individuals receive the appropriate care they need to feel better, heal or recover.

QIP models of nutrition care can highlight the importance of nutrition as a critical component to overall health in order for nutrition to be a priority for healthcare providers across different settings of care (i.e., hospital, at-home, outpatient).

Tuba: Discuss the key points of the study published in the Journal of Primary Care and Community Health supporting the use of a new health care model.

Suela Sulo: This new research with Abbott and the University of Southern California proves that, when implemented systematically, this simple but comprehensive nutrition model can promote better overall health, strengthen the quality of care, and reduce healthcare resource use. Taken together, these are all factors that can ultimately reduce healthcare costs, for providers and patients alike.

The study found that implementing a nutrition program helped improve care, reduced healthcare resource use, and lowered healthcare costs. The three clinics that participated in the study and implemented a nutrition program observed:

• 11.6% decrease in the percentage of patients using healthcare resources over 90 days, allowing healthcare providers to better manage their patients while reducing costs
• Improvement in the quality of care, with 81.8% of patients reporting high levels of satisfaction with their nutrition care
• Net savings of $495 per patient

Tuba: Discuss the role of real-world quality improvement programs (QIPs) in enlightening health care services.

Suela Sulo: Nutrition care programs, like the one implemented in this study, demonstrate the power of nutrition. Prioritizing nutrition across different settings of care, including outpatient clinics, can help healthcare providers give their patients the best chance of fast recovery that can allow them to return to living a healthy life.

Processes, like the one implemented in this study for optimizing nutrition, are sustainable, scalable, and able to be replicated. And, they are able to be applied in any health care system or outpatient clinic, whether in a rural community or a large city, they are adaptable and able to produce positive outcomes, improving patient health and reducing costs.

Tuba: What is the Malnutrition Screening Tool (MST)?

Suela Sulo: Malnutrition may be invisible to the eye and often goes undiagnosed. Many do not realize that this underlying condition can occur in individuals who are underweight or overweight, and assessing malnutrition or its risk prior to surgery or treatment is important because it can impact a patient's health outcomes.

The Malnutrition Screening Tool (MST), a validated tool, helps to screen, identify and treat people who are at risk for malnutrition. Using the Malnutrition Screening Tool takes less than 5 minutes to complete, using two simple questions looking to address:

• unintentional weight loss, and;
• poor appetite

Tuba: Do you think nutrition plays a vital role in improving the quality of care?

Suela Sulo: Prioritizing nutrition can be foundational to improving the overall quality of care, which in turn may improve health outcomes, enhance the quality of life and decrease the economic burden on individuals and our healthcare system. Research shows that when medical teams implement nutrition screenings, intervene with appropriate nutritional drinks and follow patients' nutritional status in the hospital, they help give patients the best possible chance of a successful recovery.

As providers and administrators face added pressures from rising healthcare costs, value-based nutrition interventions should be considered in acute and post-acute care institutions and health systems across the U.S. and around the world.

With this research, healthcare authorities have an opportunity to implement effective practices, policies, and comprehensive malnutrition strategies across the continuum of care at hospitals, post-acute or primary care settings, and at home, making our communities healthier for all.

Tuba: Discuss the study design in which the company implements the QIP.

Suela Sulo: QIP was informed as a real-world study to replicate current practice and to simulate the real-world patient experience. The goal is for QIPs to be sustainable, scalable, and reproducible any health system or outpatient clinic, whether in a rural community or a large city, can adopt them and see positive outcomes improve patient health and reduce costs.

Tuba: Highlight the results of the study in a non-scientific manner.

Suela Sulo: The study found that implementing screenings for nutrition helped healthcare professionals better care for patients in outpatient settings who were at risk for malnutrition. Implementing this simple step and providing patients with the nutrition and education they needed showed that patients were able to stay healthy, allowing them to recover while staying at home rather than needing to receive, and sometimes pay for, costly care in a hospital, emergency room or outpatient clinic. Moreover, the study showed that healthcare costs, which are burdensome to patients and providers, were reduced and patient satisfaction increased.

Tuba: Do you think implementing a QIP program leads to cost-saving? If yes, provide some static to justify your answers.

Suela Sulo: Addressing nutrition needs before delivering care allows health care providers to have a better picture of the patient, which allows them to deliver better solutions tailored to the patient's needs—and the data supports it. QIPs conducted in hospitals, post-acute or primary care settings, and at home, have demonstrated cost savings ranging between approximately $500-$4000 per patient as a result of reduced healthcare resource use, primarily hospitalizations. This is consistent with other published research including a recent publication by the American Society for Parenteral and Enteral Nutrition (ASPEN) showing that nutrition support therapy results in annual cost savings of $580 million on high-priority therapeutic conditions such as cancer and surgery. (Reference: Tyler R, et al. JPEN. 2020. 1'12. doi: 10.1002/jpen.1768).

Tuba: What are the clinical implications of the QIP program?

Suela Sulo: Study findings suggest that attention to nutrition care can improve patient health status and focus on minimizing the utilization of healthcare resources costs. Overall, we've seen that stakeholders across the continuum of care benefit when people are properly nourished: health systems are able to deliver quality care with reduced costs, healthcare providers are able to provide higher quality care with improved patient outcomes, and patients can feel better about the holistic regimen of care they are receiving to actively treat symptoms and successfully manage conditions.

Tuba: What are Abbott's plans to redefine healthcare in this area?

Suela Sulo: Abbott partners with leading health economists, researchers, and healthcare systems, such as the University of Southern California, to conduct numerous studies that evaluate the health benefits and cost-effectiveness of nutritional therapies across different healthcare settings, with a goal to identify solutions that lead to a better-nourished world.  By studying the role of nutrition in aging and disease management, Abbott is helping adults live more active, healthier and longer lives

Source: The Wire Science

About Suela Sulo:

Suela Sulo is the Abbott's Director of Global Health Economics, Outcomes Research, and Policy. Since joining Abbott in 2016, Suela has helped design and disseminate numerous research studies and quality improvement programs, which measure the impact of nutrition interventions on the process and patient outcomes as well as healthcare costs.

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