Barriers and facilitators to screening and treating malnutrition in older adults living in the community: a mixed-methods synthesis.
BMC Fam Pract
; 20(1): 100, 2019 07 15.
Article
em En
| MEDLINE
| ID: mdl-31307402
ABSTRACT
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. REVIEW REGISTRATIONS PROSPERO CRD42017071398 . The review protocol was registered retrospectively.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
/
Programas de Rastreamento
/
Desnutrição
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Qualitative_research
/
Screening_studies
/
Systematic_reviews
Aspecto:
Determinantes_sociais_saude
Limite:
Aged
/
Humans
Idioma:
En
Revista:
BMC Fam Pract
Ano de publicação:
2019
Tipo de documento:
Article