Screening for malnutrition in general practice: get involved!

IMG gp with patient

Malnutrition affects many older adults, and is associated with declines in overall health and quality of life, as well as lengthier hospital stays and higher mortality.

Malnutrition affects many older adults, and is associated with declines in overall health and quality of life, as well as lengthier hospital stays and higher mortality.

A recent study in Illawarra and Shoalhaven general practices suggested that over 30% of older patients that were screened were either malnourished or at risk of malnutrition.

Researchers from UOW worked with local GPs and practice nurses to develop and test the feasibility of a new model of care to detect malnutrition in older adults and to develop a clinical pathway for management. It was found that staff generally felt ill equipped about assessing risk of malnutrition and were unaware of how to advise an older patient who is identified to be at high risk.

Because of time constraints, an opportunity was seen to exist within the above 75 years Health Assessment. The recommended validated nutrition screening tool (MNA-Short Form) takes only minutes to complete, and can easily be incorporated within this Medicare funded health screen. However, uptake of the above 75 years HA is low.

The model of care is now being rolled out to practices across South Eastern NSW as a result of funding from COORDINARE. The University of Wollongong, together with Grand Pacific Health is offering general practices the opportunity to participate in this project. Training and materials are provided to practices and some remuneration is offered to practices to cover staff time. Potential benefits are shown below. 

Benefits to patients

  • increased knowledge of malnutrition and its risk factors
  • improved health outcomes associated with early detection and intervention of malnutrition
  • take home resource with practical nutrition tips
  • localised service directory
  • cohesive health care service from familiar practice staff

Benefits to clinical staff

  • upskilling in malnutrition identification and management
  • one hour CPD with APNA endorsement
  • supporting best practice guidelines
  • accurate screening tool with low time burden
  • access to malnutrition toolkit, including; validated malnutrition screening tool, easy to follow action pathway, electronic patient resources and local service directory with referral pathways

Benefits to practice

  • opportunity for promotion of high level patient care in local media
  • one hour training provided on-site to minimise disruption to clinical time
  • financial support for upgrading relevant equipment
  • practice support from project team member
  • published research at completion of project

The project leader Associate Professor, Karen Charlton, sees this as "an excellent example of how the general practices within the local PHN are leading the way in delivering innovative and high quality care to meet the needs of the older sector of the population."

"We have already demonstrated proof of concept for routine malnutrition screening, now we need to show that this can be rolled out on a larger scale. This is a win-win that can benefit both practices as well as improve patient outcomes," she said.

Project team member, Prof Andrew Bonney, stated “as a GP in a community with a high proportion of older persons, I am excited about this project that fills an important clinical need with minimal disruption to practice work flow."

If your practice is interested in participating in this project, please see the expression of interest, or for more information from the GPH project team please call (02) 4448 2233 or email dietitian@gph.org.au or contact Associate Professor Karen Charlton at karenc@uow.edu.au or (02) 4221 4754.