eprintid: 10136881 rev_number: 15 eprint_status: archive userid: 608 dir: disk0/10/13/68/81 datestamp: 2021-10-25 11:05:51 lastmod: 2022-10-13 09:50:32 status_changed: 2021-10-25 11:05:51 type: article metadata_visibility: show creators_name: Keetarut, K creators_name: Kikuchi, H creators_name: King, B creators_name: Richards, N creators_name: Lomer, M creators_name: Fragkos, K creators_name: Patel, PS title: Perceived acceptability of partial enteral nutrition (PEN) using oral nutritional supplement drinks in adolescent and adult Crohn’s Disease outpatients: a feasibility study ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 keywords: Crohn’s disease, partial enteral nutrition, acceptability, long term use, benefits, barriers note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. abstract: BACKGROUND AND AIMS: Studies, mainly in Japanese cohorts, have shown that partial enteral nutrition (PEN) including oral nutritional supplement (ONS) drinks can prolong disease remission and increase drug effectiveness in Crohn’s disease (CD). Acceptability is a key feasibility parameter to determine whether PEN is a viable treatment option in UK CD patients. We report the results of a single centre cross-sectional feasibility study carried out to investigate perceived acceptability of PEN using ONS drinks and whether ONS preference varies with sex, nutritional status or phenylthiocarbamide (PTC) sensitivity. METHODS: Patients with a confirmed CD diagnosis were recruited using convenience sampling from an adult and adolescent gastroenterology outpatient clinic over 3 years. Blind taste testing of 5 polymeric ONS drinks was conducted using a validated 9-point hedonic rating scale followed by completion of the acceptability questionnaire based on the preferred ONS drink. A subset of patients took home the preferred ONS for a 7-day study. RESULTS: 105 CD patients (55 males), aged 34.9 (±15.4) years were recruited and 28 patients completed the 7-day ONS study. Overall impression scores did not significantly vary with nutritional status, sex, BMI, handgrip strength (HGS), mid-upper arm circumference (MUAC) or PTC sensitivity. Ensure plus™ milkshake rated highest for overall impression (6.5, p=<0.0001) and all other organoleptic properties (p<0.0001). The main perceived benefits of using ONS drinks as PEN related to assurance of nutrient intake (89.3%), convenience (85.7%), and improvement of gut symptoms (84.6%). The main perceived barriers related to reduction in pleasure from eating and drinking (55.6%), struggle with drink storage (53.6%) and increased tiredness than if eating 3 solid meals daily (52%%). 64.8% of patients would consider using PEN as a maintenance treatment option. 81.0% of patients felt confident about consuming ONS drinks daily as PEN for three months but this dropped to 63.8% and 37.1% at 6 and 12 months, respectively. There was a significant drop in perceived ease of use as PEN after the 7-day ONS study (P=0.01). CONCLUSION: Use of ONS drinks as PEN have high perceived benefits and appear to be a feasible option for short-term use of 3-6 months in CD patients. However, confidence in long-term use of ONS drinks as PEN is low mainly due to the perceived social impact. Future studies should assess longer trial periods and volume of ONS drinks to increase the validity of these findings. date: 2021-12-01 date_type: published publisher: Elsevier BV official_url: https://doi.org/10.1016/j.clnesp.2021.09.742 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1894674 doi: 10.1016/j.clnesp.2021.09.742 lyricists_name: Fragkos, Konstantinos lyricists_id: FKONS73 actors_name: Fragkos, Konstantinos actors_id: FKONS73 actors_role: owner full_text_status: public publication: Clinical Nutrition ESPEN volume: 46 pagerange: 276-287 citation: Keetarut, K; Kikuchi, H; King, B; Richards, N; Lomer, M; Fragkos, K; Patel, PS; (2021) Perceived acceptability of partial enteral nutrition (PEN) using oral nutritional supplement drinks in adolescent and adult Crohn’s Disease outpatients: a feasibility study. Clinical Nutrition ESPEN , 46 pp. 276-287. 10.1016/j.clnesp.2021.09.742 <https://doi.org/10.1016/j.clnesp.2021.09.742>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10136881/1/Keetarut%20et%20al%202021.pdf