Iron and calcium requirements for home enteral nutrition patients: an Australian audit
This work was presented at the European Society of Parenteral and Enteral Nutrition 2023 by the Tube Dietitian Team.
The abstract has been published in the conference journal and can be found here.
Rationale: Micronutrients can be overlooked for people on home enteral nutrition. This study aimed to determine what proportion of patients are meeting their recommended intake and upper level of intake for iron and calcium.
Methods: This retrospective medical record audit used initial nutrition assessments from a community-based home enteral nutrition service in Victoria, Australia. Iron and calcium quantities were calculated on the composition and delivery amount of the commercial formula. Quantities were compared to each patient's recommended intake (daily intake intended to meet the needs of 97% to 98% of a healthy population) and the upper level of intake (highest daily intake unlikely to pose adverse health effects). Outcomes were analysed by gender and formula concentration, with the number of patients expressed as a proportion of these intakes. Descriptive statistics were performed.
Results: Fifty-two patients were included (50% males, 51 (18-96) years of age, 894 ml (237-1683 ml) average formula delivered per day). Majority had a neurological diagnosis (n=43, 83%). Nutrition delivery met the recommended intake for iron and calcium in 75% and 35% of patients, respectively. More men than women met the recommended intake for iron (96% vs. 54%, respectively) and calcium (54% vs. 15%, respectively). By formula concentration, the highest proportion of patients who met the recommended intake for iron were on a 2.0kcal/ml (75%) and the highest proportion who met the recommended intake for calcium were on a 1.0kcal/ml (40%). No patient exceeded the upper level of intake for either.
Conclusion: This audit demonstrates inconsistencies in the proportion of adults meeting the recommended intake for iron and calcium. Clinicians should consider patients' demographics in relation to micronutrient requirements and formula choice. Further research is required to verify these findings.
Disclosure of Interest: None declared