Priority setting for malnutrition and nutritional screening in healthcare: A James Lind Alliance

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Malnutrition is one of the greatest global health challenges of our generation [1] and in the UK 2.65 million people are affected, costing the NHS £19.6 billion each year [2, 3].

Determining research priorities and setting research agendas has traditionally had little involvement from patients and carers. Nutrition research is often steered by industry, academia and government committees and there has been limited opportunity for dietitians and health care professionals working directly in nutrition to contribute to setting research priorities.

The aim of this project was to establish a priority setting partnership to give patients, carers and health care professionals the opportunity to influence research priorities in malnutrition. A national survey was conducted to gather uncertainties from those with experience of malnutrition. Respondents were obtained by advertising through JLA malnutrition partners, including both professional and charitable organisations. Uncertainties were submitted in the form of questions, which were inputted on to a database and analysed according to themes. Similar questions were grouped together and summary questions were developed, which were transferred to a second interim survey. The interim survey was conducted online and respondents were asked to choose their 10 most important questions. Data were used to generate a list of the top questions, for presentation at the final workshop.

Overall, 1128 uncertainty questions were submitted from 268 people including 194 professionals and 74 patients and carers. From the submitted questions we created a second survey, where 71 people responded and a list of the top 26 questions was generated to go forward to a final workshop. The final workshop was held in Manchester in June 2019. The workshop was facilitated by JLA and attended by 12 professionals and five patients/carers. The 26 questions were discussed and ranked in small groups and then agreed by all participants before the final top 10 research priorities were chosen.

Top 10 Research priorities
1. How can early intervention be initiated in vulnerable groups to help prevent malnutrition?
2. What is the best way to carry out screening in the community for effective identification of malnutrition?
3. Are people/patients aware of malnutrition, do they know how to prevent it and do they feel screening is important?
4. Should multi agency working be implemented across all care settings?
5. How useful are nutritional supplements, are there alternatives?
6. Should nutritional treatment be geared to specific disease states and patient groups?
7. What types of community support could be used to prevent malnutrition?
8. Is there evidence that treating malnutrition in the community would affect use of healthcare resources?
9. Can technology and electronic records be used to record and improve nutritional treatments?
10. Is it appropriate and accurate to use standard BMI ranges to diagnose malnutrition in elderly people?

It is anticipated that these priorities will be used nationally to inform the research agenda in malnutrition and nutritional screening.
Original languageEnglish
Article numberOC49
Pages (from-to)230
Number of pages231
JournalClinical Nutrition ESPEN
Issue numberFeb 2020
Publication statusPublished - 1 Feb 2020


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