OBJECTIVE: Assess the effect of intensive nutrition education by trained dedicated dietitians on osteodystrophy management among hemodialysis patients. METHODS: Randomized controlled trial in 12 hospital-based hemodialysis units equally distributed over clusters 1 and 2. Cluster 1 patients were either assigned to usual care (n=96) or to individualized intensive staged-based nutrition education by a dedicated renal dietitian (n=88). Cluster 2 patients (n=210) receivednutrition education from general hospital dietitians, educating their patients at their spare time from hospital duties. Main outcomes were: (1) dietary knowledge(%), (2) behavioral change, (3) serum phosphorus (mmol/L), each measured at T0 (baseline), T1 (post 6 month intervention) and T2 (post 6 month follow up). RESULTS: Significant improvement was found only among patients receiving intensive education from a dedicated dietitian at T1; the change regressed at T2 without statistical significance: knowledge (T0: 40.3; T1: 64; T2: 63) and serum phosphorus (T0: 1.79; T1: 1.65; T2: 1.70); behavioral stages changed significantly throughout the study (T0: Preparation, T1: Action, T2: Preparation). CONCLUSION: The intensive protocol showed to be the most effective. PRACTICE IMPLICATIONS: Integrating dedicated dietitians and stage-based education in hemodialysis units may improve the nutritional management of patients in Lebanon and countries with similar health care systems.
RCT Entities:
OBJECTIVE: Assess the effect of intensive nutrition education by trained dedicated dietitians on osteodystrophy management among hemodialysis patients. METHODS: Randomized controlled trial in 12 hospital-based hemodialysis units equally distributed over clusters 1 and 2. Cluster 1 patients were either assigned to usual care (n=96) or to individualized intensive staged-based nutrition education by a dedicated renal dietitian (n=88). Cluster 2 patients (n=210) received nutrition education from general hospital dietitians, educating their patients at their spare time from hospital duties. Main outcomes were: (1) dietary knowledge(%), (2) behavioral change, (3) serum phosphorus (mmol/L), each measured at T0 (baseline), T1 (post 6 month intervention) and T2 (post 6 month follow up). RESULTS: Significant improvement was found only among patients receiving intensive education from a dedicated dietitian at T1; the change regressed at T2 without statistical significance: knowledge (T0: 40.3; T1: 64; T2: 63) and serum phosphorus (T0: 1.79; T1: 1.65; T2: 1.70); behavioral stages changed significantly throughout the study (T0: Preparation, T1: Action, T2: Preparation). CONCLUSION: The intensive protocol showed to be the most effective. PRACTICE IMPLICATIONS: Integrating dedicated dietitians and stage-based education in hemodialysis units may improve the nutritional management of patients in Lebanon and countries with similar health care systems.
Authors: Christine Baldwin; Marian Ae de van der Schueren; Hinke M Kruizenga; Christine Elizabeth Weekes Journal: Cochrane Database Syst Rev Date: 2021-12-21
Authors: Karumathil M Murali; Judy Mullan; Steven Roodenrys; Hicham C Hassan; Kelly Lambert; Maureen Lonergan Journal: PLoS One Date: 2019-01-29 Impact factor: 3.240
Authors: Cosette Fakih El Khoury; Mirey Karavetian; Ruud J G Halfens; Rik Crutzen; Dayana El Chaar; Jos M G A Schols Journal: Healthc Inform Res Date: 2019-10-31
Authors: Ahmed A Al-Jaishi; Kelly Carroll; Cory E Goldstein; Stephanie N Dixon; Amit X Garg; Stuart G Nicholls; Jeremy M Grimshaw; Charles Weijer; Jamie Brehaut; Lehana Thabane; P J Devereaux; Monica Taljaard Journal: Trials Date: 2020-08-28 Impact factor: 2.279