Manpreet S Mundi1, Saketh Velapati1, Aravind R Kuchkuntla1, Ryan T Hurt2. 1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA. 2. Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Abstract
BACKGROUND: Since the introduction of percutaneous endoscopic gastrostomy in the 1980s, the prevalence of home enteral nutrition (HEN) support has increased significantly. Despite these increases, many patients are unable to tolerate standard polymeric formulas (SPFs), resulting in significant healthcare resource utilization. Peptide-based diets (PBDs) have emerged as a viable option in SPF-intolerant patients; however, data in the HEN population are lacking. METHODS: Retrospective review of our prospectively maintained HEN database was conducted to assess tolerance, efficacy, and impact on healthcare utilization in patients on PBDs. RESULTS: From January 1, 2016, to May 1, 2018, 95 patients were placed on PBDs, with 53 patients being started directly and 42 patients being transitioned from SPFs. In patients transitioned to PBDs, symptoms of nausea and vomiting, diarrhea, abdominal pain, and distention improved significantly. Healthcare utilization also declined significantly, including mean number of phone calls (1.8 ± 1.6 to 1.1 ± 0.9, P = 0.006), mean number of emergency room visits (0.3 ± 0.6 to 0.09 ± 0.3, P = 0.015), and mean number of provider visits (1.3 ± 1.3 to 0.3 ± 0.5, P < 0.0001). CONCLUSIONS: Overall, PBDs were well tolerated and resulted in significant improvements in symptoms of gastrointestinal distress and healthcare utilization in patients intolerant to SPFs.
BACKGROUND: Since the introduction of percutaneous endoscopic gastrostomy in the 1980s, the prevalence of home enteral nutrition (HEN) support has increased significantly. Despite these increases, many patients are unable to tolerate standard polymeric formulas (SPFs), resulting in significant healthcare resource utilization. Peptide-based diets (PBDs) have emerged as a viable option in SPF-intolerantpatients; however, data in the HEN population are lacking. METHODS: Retrospective review of our prospectively maintained HEN database was conducted to assess tolerance, efficacy, and impact on healthcare utilization in patients on PBDs. RESULTS: From January 1, 2016, to May 1, 2018, 95 patients were placed on PBDs, with 53 patients being started directly and 42 patients being transitioned from SPFs. In patients transitioned to PBDs, symptoms of nausea and vomiting, diarrhea, abdominal pain, and distention improved significantly. Healthcare utilization also declined significantly, including mean number of phone calls (1.8 ± 1.6 to 1.1 ± 0.9, P = 0.006), mean number of emergency room visits (0.3 ± 0.6 to 0.09 ± 0.3, P = 0.015), and mean number of provider visits (1.3 ± 1.3 to 0.3 ± 0.5, P < 0.0001). CONCLUSIONS: Overall, PBDs were well tolerated and resulted in significant improvements in symptoms of gastrointestinal distress and healthcare utilization in patients intolerant to SPFs.
Authors: Marcin Folwarski; Stanisław Kłęk; Agata Zoubek-Wójcik; Waldemar Szafrański; Lidia Bartoszewska; Krzysztof Figuła; Marlena Jakubczyk; Anna Jurczuk; Zbigniew Kamocki; Tomasz Kowalczyk; Bogna Kwella; Przemysław Matras; Joanna Sonsala-Wołczyk; Jacek Szopiński; Krystyna Urbanowicz; Anna Zmarzły Journal: Front Nutr Date: 2022-07-07
Authors: Osman Mohamed Elfadil; Dana B Steien; Ramya Narasimhan; Saketh R Velapati; Lisa Epp; Ishani Patel; Jalpan Patel; Ryan T Hurt; Manpreet S Mundi Journal: JPEN J Parenter Enteral Nutr Date: 2021-07-19 Impact factor: 3.896