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Evaluation of an online malnutrition management education module for general practitioners: the ONSPres project

Published online by Cambridge University Press:  17 August 2021

A.A. Geraghty
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
P. Dominguez Castro
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
C.M.E. Reynolds
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
L. McBean
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
B. Clyne
Affiliation:
HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
G. Bury
Affiliation:
School of Medicine, University College Dublin, Belfield, Dublin, Ireland
F. Bourke
Affiliation:
Royal College of Surgeons in Ireland, Dublin, Ireland
C. Bradley
Affiliation:
Royal College of Surgeons in Ireland, Dublin, Ireland
K. Finnigan
Affiliation:
Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
S. Clarke
Affiliation:
Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Ireland
C. Perrotta
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland
L. McCullagh
Affiliation:
National Centre for Pharmacoeconomics, St James's Hospital, Dublin, Ireland
C. Murrin
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
E.R. Gibney
Affiliation:
UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland School of Agriculture and Food Science, University College Dublin, Belfield, Dublin, Ireland
S. Kennelly
Affiliation:
National Primary Care Division, Community Funded Schemes Service Improvement, Mountmellick Primary Care Building, Laois, Ireland
C.A Corish
Affiliation:
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
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Abstract

Type
Abstract
Copyright
Copyright © The Authors 2021

Malnutrition is common, yet under-diagnosed, amongst community-dwelling older adults(Reference Leij-Halfwerk, Verwijs and van Houdt1). General practitioners (GPs) are generally the first healthcare point of contact for older adults; however, currently there is little nutrition education in medical training and GPs report a lack of confidence in diagnosing and treating malnutrition(Reference Nowson2,Reference Castro P, Reynolds and Kennelly3) . To address this, GP interviews were carried out to establish preferences for the delivery and content of a malnutrition education programme and an online education module was designed. Efficacy of the module in improving knowledge and practice was evaluated.

Thirty-one GPs and GP trainees participated. The module covered the following topics: ‘malnutrition definition, prevalence and latest evidence’, ‘identifying malnutrition in clinical practice’, ‘food-first advice’, ‘reviewing malnutrition’ and ‘oral nutritional supplements’. Knowledge was measured using a multiple-choice questionnaire (MCQ). Practice was evaluated using patient case studies at baseline, immediately post-module completion, and 6-weeks post-module. Case studies involved calculations of weight loss, malnutrition risk scores, and approaches to treatment and follow-up, which were then reviewed by a clinical specialist dietitian for older adults. Evaluation forms assessing feedback from the module were also completed. Differences between assessment performance were investigated using paired t-tests.

MCQ scores increased significantly from baseline to immediately post-module (+25%, P < 0.001), with the greatest improvement in the ‘identifying malnutrition in clinical practice’ topic (+47%, P < 0.001). Eleven GPs completed the 6-week MCQ when scores remained significantly increased from baseline (+14%, P = 0.005), with the largest increase remaining in the ‘identifying malnutrition in clinical practice’ topic (+40%, P < 0.001). Seventeen GPs completed the case studies with 85% correctly calculating malnutrition risk scores at baseline, increasing to 94% post-module. Identification of appropriate approaches to malnutrition treatment improved by 33% after module completion. GP feedback about the module was positive.

This online education module was well-received by GPs and was successful in improving malnutrition knowledge and practice, with this improvement being retained in the short-term. Future development of nutrition online education tools that promote evidence-based practical learning may represent an effective way to improve nutrition care provided by GPs.

Acknowledgements

This project was funded by the Health Research Board (HRB) under a quality and patient safety funding stream (RCQPS-2017–4).

References

Leij-Halfwerk, S, Verwijs, MH, van Houdt, S, et al. (2019) Maturitas, 126, 80–9.10.1016/j.maturitas.2019.05.006CrossRefGoogle Scholar
Nowson, C (2020) BMJ NPH 0, 13Google Scholar
Castro P, Dominguez, Reynolds, CM, Kennelly, S, et al. (2020) Clin Nutr ESPEN, 36, 116–2710.1016/j.clnesp.2020.01.006CrossRefGoogle Scholar