Study maps strategies to improve life for patients on permanent IV nutrition
Researchers identified 11 management approaches that help patients with intestinal failure maintain quality of life while dependent on home intravenous feeding. The findings could guide healthcare providers and medical device companies in designing better support systems, though experts warn the evidence base remains weak and needs strengthening.
Originaltitel: Management strategies for home parenteral support related to quality of life in intestinal failure patients: A scoping review.
Elva olika vårdstrategier för hemmaaktuell nutrition kan förbättra livskvaliteten hos patienter med kronisk tarmsvikt, visar en vetenskaplig kartläggning från Sahlgrenska och Karolinska universitetsjukhus tillsammans med Rigshospitalet i Köpenhamn. Forskarna analyserade 18 studier och klassificerade strategierna i tre områden: ordinationer, administrationspraxis och självvårdsverktyg. Resultaten indikerar att väl utformad hemmabehandling av parenteral nutrition påtagligt påverkar patienternas dagliga funktionsförmåga och välbefinnande under långtidsbehandling. Bristande evidensunderlag försvagar dock implikationerna — endast ett fåtal strategier är utredda i mer än två studier. För regionala inköpschefer och kliniker som utformar ernäringsprotokoll är detta relevant för standardisering av hemvård och riskreducering. Framtida högkvalitativ forskning behövs innan större investering i nya administrationsmodeller motiveras.
BACKGROUND: Quality of life in patients with chronic intestinal failure is challenged by the need for long-term home parenteral support. The aim of this study was to identify healthcare initiated home parenteral support management strategies related to quality of life in patients with intestinal failure. METHODS: A systematic search was conducted across two databases (PUBMED, CINAHL) on the 27th of April 2024. Search results were mapped according to the JBI manual with the extraction tool Covidence. Non-pharmacological home parenteral support management strategies were included. Full-text screening was performed independently by four researchers, and three researchers systematically processed the data extraction pairwise. RESULTS: A total of 18 studies were included. Eleven unique home parenteral support management strategies were identified and grouped into 3 themes: prescription, administration, and tools for self-care. CONCLUSION: This study indicates that management strategies of home parenteral support can play a valuable role in improving the quality of life for those depending on long-term intravenous treatment. However, there is a lack of high-quality evidence and only a few strategies have been investigated in more than two studies.