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.
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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.
| Type: | Article |
|---|---|
| Title: | Perceived acceptability of partial enteral nutrition (PEN) using oral nutritional supplement drinks in adolescent and adult Crohn’s Disease outpatients: a feasibility study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.clnesp.2021.09.742 |
| Publisher version: | https://doi.org/10.1016/j.clnesp.2021.09.742 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions. |
| Keywords: | Crohn’s disease, partial enteral nutrition, acceptability, long term use, benefits, barriers |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10136881 |
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