Introduction Early identification of patients at risk of malnutrition and onward referral to dietetic service is advocated in best practice guidelines.¹Patients who are housebound are not able to attend dietitian clinic appointments require a domiciliary community dietetic service (CNDS). Data is lacking in relation to the patients’ experience of this type of service in the Irish setting.

Aim To investigate patient experience and satisfaction with CNDS domiciliary service for patients at risk of malnutrition in 4 midlands counties in the Republic of Ireland (ROI).

Method A random sample of patients who were actively receiving a domiciliary service from the CNDS were contacted and invited to be interviewed by an independent dietitian researcher at their home. A semi-structured interview-assisted questionnaire was used. The interview was audio-recorded and later transcribed for content analysis.

Results Out of 20 patients contacted by the researcher, 12 participants (4 male, 8 female) were available to take part in the study. In 2/10 cases carers were interviewed as a proxy for patients who had advanced dementia. Average age of patients was 79 years (Range 62–94 years).

All participants (n = 12) could recall the last visit they had received from the community dietitian (CD). All (n = 12) were satisfied with the service provided and many commented that a domiciliary visit made them feel supported. The majority of patients (10/12) felt they needed a domiciliary service. Most (10/12) participants could recall advice given by the CD however only half of those surveyed felt they were coping better with their diet (including supplement usage) after receiving the advice. “I’ve become more aware what I should and should not do’. Seven out of 12 participants felt the CNDS service had improved their overall quality of life such as improved health, energy, and appetite.

Conclusion The finding that all patients receiving a domiciliary service from the CNDS are satisfied with the service and assessment carried out by the dietitan is encouraging. However the results suggest that many patients requiring a domically CNDS service still struggle to cope with dietary changes to improve nutritional intake despite receiving dietary advice and prescribed oral nutritional supplements.

Disclosure of interest None Declared.

Reference

1. Nutrition support in adults: oral nutritional support, enteral tube feeding, and parenteral nutrition (2006). London, National Institute for Health and Clinical Excellence (NICE)