Barriers and facilitators to screening and treating malnutrition in older adults living in the community : a mixed-methods synthesis

Harris, PS, Morrison, L, Green, SM, Ghio, D ORCID:, Hallett, C, Parsons, EL, Aveyard, P, Roberts, HC, Sutcliffe, M, Robinson, S, Slodkowska-Barabasz, J, Little, PS, Stroud, MA and Yardley, L 2019, 'Barriers and facilitators to screening and treating malnutrition in older adults living in the community : a mixed-methods synthesis' , BMC Family Practice, 20 (100) .

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Background Malnutrition (specifically undernutrition) in older, community-dwelling adults reduces well-being and predisposes to disease. Implementation of screen-and-treat policies could help to systematically detect and treat at-risk and malnourished patients. We aimed to identify barriers and facilitators to implementing malnutrition screen and treat policies in primary/community care, which barriers have been addressed and which facilitators have been successfully incorporated in existing interventions.
Method A data-base search was conducted using MEDLINE, Embase, PsycINFO, DARE, CINAHL, Cochrane Central and Cochrane Database of Systematic Reviews from 2012 to June 2016 to identify relevant qualitative and quantitative literature from primary/community care. Studies were included if participants were older, community-dwelling adults (65+) or healthcare professionals who would screen and treat such patients. Barriers and facilitators were extracted and mapped onto intervention features to determine whether these had addressed barriers.
Results Of a total of 2182 studies identified, 21 were included (6 qualitative, 12 quantitative and 3 mixed; 14 studies targeting patients and 7 targeting healthcare professionals). Facilitators addressing a wide range of barriers were identified, yet few interventions addressed psychosocial barriers to screen-and-treat policies for patients, such as loneliness and reluctance to be screened, or healthcare professionals’ reservations about prescribing oral nutritional supplements.
Conclusion The studies reviewed identified several barriers and facilitators and addressed some of these in intervention design, although a prominent gap appeared to be psychosocial barriers. No single included study addressed all barriers or made use of all facilitators, although this appears to be possible. Interventions aiming to implement screen-and-treat approaches to malnutrition in primary care should consider barriers that both patients and healthcare professionals may face.

Item Type: Article
Schools: Schools > School of Health and Society > Centre for Health Sciences Research
Journal or Publication Title: BMC Family Practice
Publisher: BioMed Central
ISSN: 1471-2296
Related URLs:
Funders: NIHR Programme Grant for Applied Research
Depositing User: Dr Daniela Ghio
Date Deposited: 13 Mar 2020 09:53
Last Modified: 16 Feb 2022 04:13

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