KEUNTUNGAN HOSPITAL-MADE ORAL NUTRITION SUPPLEMENT TERHADAP LUARAN RUMAH SAKIT DAN ASUPAN MAKANAN PASIEN DEWASA DENGAN RISIKO MALNUTRISI DI RUMAH SAKIT
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Abstract
Kariadi Hospital Semarang produces hospital-made oral Nutrition Supplements (HM-ONS) with macronutrient content equivalent to commercial Oral Nutrition Supplements (C-ONS) at a lower cost. Clinical trials are needed to determine the impact of HM-ONS administration on changes in body weight (BW), energy and protein intake, Patient Generated Subjective Global Assessment (PG-SGA) score, Quality of Life (QoL) score, and Hand Grip Strength (HGS) of adult patients compared to C-ONS. This study was a quasi-experimental design with a randomized pre-post test control group design, using a 1:1 participant matching sampling method of 56 adult patients. Both groups received HM-ONS or C-ONS providing 400 kcal for a 5-day duration. The difference test before and after the intervention utilized a paired t-test, and the difference test between groups was conducted using an independent t-test. The results demonstrated a significant difference in both groups before and after the intervention of PG-SGA scores, mental QoL, energy intake, and protein intake (p < 0.05). The HM-ONS group demonstrated a greater increase in protein intake compared to C-ONS of 8.01 [95 percent CI 0.84 to 15.17; p=0.046] and a higher PG-SGA score of 3.03 [95 percent CI -0.28 to 6.35; p=0.013]. The short-term consumption of ONS affects nutritional status and energy intake. In addition, HM-ONS can be an alternative to C-ONS in hospitalized patients at risk of malnutrition.
Keywords: oral nutrition supplement, malnutrition
ABSTRAK
Instalasi gizi RSUP dr. Kariadi Semarang memproduksi Hospital Made Oral Nutrition Supplement (HM- ONS) dengan zat gizi makro setara dengan Oral Nutrition Supplement komersial (ONS-K) serta biaya lebih murah. Diperlukan uji klinis untuk mengetahui pengaruh pemberian HM-ONS terhadap perubahan berat badan (BB), asupan energi dan protein, skor Patient Generated Subjective Global Assessment (PG-SGA), skor Quality of Life (QoL), Hand Grip Strength (HGS) pasien dewasa dibandingkan dengan pemberian ONS-K. Penelitian ini eksperimen semu dengan randomized pre-post test control group design, pengambilan sampel dengan matching partisipan 1: 1 untuk 56 pasien dewasa. Kedua kelompok diberikan HM-ONS atau ONS-K sebanyak 400 kkal selama 5 hari. Uji beda sebelum dan sesudah intervensi menggunakan paired t-test dan uji beda antar kelompok dilakukan independent t-test. Hasil penelitian menunjukkan perbedaan yang signifikan pada rerata skor PG-SGA, asupan energi dan protein (p < 0.05) pada kedua kelompok sebelum dan sesudah intervensi. Terdapat perbedaan kenaikan asupan protein pada kelompok HM-ONS dibanding ONS-K 8·01 [95%CI 0·84 to 15.17; p=0.046] dan skor PG-SGA 3.03 [95%CI -0.28 to 6.35; p=0.013]. Pemberian ONS jangka pendek berpengaruh terhadap status gizi dan asupan energi. HM-ONS bisa menjadi alternatif pengganti ONS-K pada pasien rawat inap dengan risiko malnutrisi.
Kata kunci: oral nutrition supplement, malnutrisi
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References
Cass AR, Charlton KE. Prevalence of hospital-acquired malnutrition and modifiable determinants of nutritional deterioration during inpatient admissions: A systematic review of the evidence. J Hum Nutr Diet. 2022;35(6):1043-1058. doi:10.1111/jhn.13009
Brindisi M claude, Noacco A, Ait A, Hansal B. Clinical Nutrition ESPEN Delivery of oral nutrition supplement in hospital : Evaluation of professional practices in evaluation of nutritional status and representations of ONS by the caregivers and patients. 2019;(xxxx). doi:10.1016/j.clnesp.2019.11.005
Thomson KH, Rice S, Arisa O, et al. Articles Effectiveness and cost-effectiveness of oral nutritional supplements in frail older people who are malnourished or at risk of malnutrition : a systematic review and meta-analysis. Lancet Heal Longev. 2022;3(10):e654--e666. doi:10.1016/S2666-7568(22)00171-4
Ferreira ACR de M, Cruz MMS, Siviero L, Rabito EI. Can oral nutritional supplements increase energy and protein intake among hospitalized patients? Rev Chil Nutr. 2020;47(4):597-603. doi:10.4067/S0717-75182020000400597
Cawood AL, Elia M, Stratton RJ. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev. 2012;11(2):278-296. doi:10.1016/j.arr.2011.12.008
Schueren MAED Van Der, Laviano A, Blanchard H, Jourdan M, Arends J, Baracos VE. Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo ( radio ) therapy : current evidence and guidance for design of future trials. 3 or 6 Mon Adjuv Chemother patients with stage III colon cancer?. 2018;29(5):1141-1153. doi: 10.1093/annonc/mdy114
Hevilla F, Padial M, Blanca M, Ramirez-ortiz M, Nogueira Á, Gentile A. Effect on nutritional status and biomarkers of inflammation and oxidation of an oral nutritional supplement (with or without probiotics) in malnourished hemodialysis patients. A multicenter randomized clinical trial “Renacare Trial.” 2023;(February). doi: 10.3389/fnut.2023.1107869
Li M, Jia N, Lenzen M, et al. Global food-miles account for nearly 20% of total food-systems emissions. Nat food. 2022;3(6):445-453. doi:10.1038/s43016-022-00531-w
Lestari S, Rahmawati A M, Shita J D, Eka T L. Modifikasi Formula Enteral Rumah Sakit Siap Seduh. J Gizi Dan Kesehat. 2019;11(26):11-18. doi:10.35473/jgk.v11i26.51
Jayawardena R, Wickramawardhane P, Dalpatadu C, Hills AP, Ranasinghe P. The impact of an oral nutritional supplement on body weight gain in older adults with malnutrition: an open-label randomized controlled trial. Trials. 2023;24(1):625. doi:10.1186/s13063-023-07622-4
Stewart A, Marfell-Jones M, Olds T, Ridder H de. International Standards for Anthropometric Assessment. International Society for the Advancement of Kinanthropometry (ISAK); 2011.
Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C. Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai setting and association with nutritional parameters in cancer patients. Asian Pacific J Cancer Prev. 2019;20(4):1249-1255. doi:10.31557/APJCP.2019.20.4.1249
Wicaksana AL, Maharani E, Hertanti NS. The Indonesian version of the Medical Outcome Survey - Short Form 12 version 2 among patients with cardiovascular diseases. Int J Nurs Pract. 2020;26(2):e12804. doi:10.1111/ijn.12804
Tipton K, Leas B, Mull NK, et al. Interventions to decrease hospital length of stay. Rockv Agency Healthc Res Qual (US); 2021 Sep Rep No 21-EHC015. 2021;(40):1-147. www.ahrq.gov
Lester S, Kleijn M, Cornacchia L, Hewson L, Taylor MA, Fisk I. Factors Affecting Adherence, Intake, and Perceived Palatability of Oral Nutritional Supplements: A Literature Review. J Nutr Health Aging. 2022;26(7):663-674. doi:10.1007/s12603-022-1819-3
Ferreira A, Cruz M, Siviero L, Rabito E. Can oral nutritional supplements increase energy and protein intake among hospitalized patients? Rev Chil Nutr. 2020;47:597-603. doi:10.4067/S0717-75182020000400597
Myint MWW, Wu J, Wong E, et al. Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial. Age Ageing. 2013;42(1):39-45. doi:10.1093/ageing/afs078
Svendsen JA, Raben I, Holskou M, Dynesen AW. Nutritional risk, nutrition impact symptoms, and dietary intake after four or more days of admission: A cross-sectional study on hospitalised patients. Clin Nutr Open Sci. 2024;58:121-130. doi:10.1016/j.nutos.2024.09.011
Tyastuti LE, Purwaningsih S, Suswan W. Nutrition Impact Symptom dan Malnutrisi pada Pasien Onkologi dengan Kemoterapi. Temu Ilm Nas Persagi. 2022;4:149-158.
Yeung SSY, Lee JSW, Kwok T. A Nutritionally Complete Oral Nutritional Supplement Powder Improved Nutritional Outcomes in Free-Living Adults at Risk of Malnutrition : A Randomized Controlled Trial. Published online 2022.
Habibi S, Ghoreishy SM, Imani H, Barkhordar M, Vaezi M. The effect of oral nutrition supplement ( ONS ) on the nutritional and clinical status of patients undergoing autologous hematopoietic stem cell transplantation : study protocol for a randomized controlled clinical trial. Published online 2024:1-8.
Milne AC, Potter J, Vivanti A, Avenell A. Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane database Syst Rev. 2009;2009(2):CD003288. doi: 10.1002/14651858.CD003288.pub3
Deakin University. Nutrition Assesment.; 2019.
Dou S, Ding H, Jiang W, et al. Effect of oral supplements on the nutritional status of nasopharyngeal carcinoma patients undergoing concurrent chemotherapy: A randomized controlled Phase II trial. J Cancer Res Ther. 2020;16(7):1678-1685. doi:10.4103/jcrt.JCRT_273_20
Huong LT, Phuong DT, Anh DK, et al. Nutritional Intervention Improves Nutrition Outcomes in Stomach and Colon Cancer Patients Receiving Chemotherapy: Finding from a Quasi-Experiment in Vietnam. Healthc (Basel, Switzerland). 2021;9(7). doi:10.3390/healthcare9070843
Lin Y, Chattopadhyay K. Effects of post-discharge oral nutrition supplement on nutritional status and body composition in malnourished patients with gastrointestinal cancer and the clinical implications. Res Sq. Published online 2023:1-19.
Qin N, Jiang G, Zhang X, Sun D, Liu M. The Effect of Nutrition Intervention With Oral Nutritional Supplements on Ovarian Cancer Patients Undergoing Chemotherapy. Front Nutr. 2021;8:685967. doi:10.3389/fnut.2021.685967
Sa-Nguansai S, Pintasiri P, Tienchaiananda P. Efficacy of oral nutritional supplement in cancer patients receiving chemotherapy: a systematic review and meta-analysis of randomized controlled trials. Ann Palliat Med. 2024;13(2):260-272. doi:10.21037/apm-23-558
Azevedo MD, de Pinho NB, de Carvalho Padilha P, de Oliveira LC, Arantes Ferreira Peres W. Clinical usefulness of the patient-generated subjective global assessment short form© for nutritional screening in patients with head and neck cancer: a multicentric study. Ecancermedicalscience. 2024;18:1-10. doi:10.3332/ECANCER.2024.1662
Zhang Z, Li Q, Jiang L, et al. Effectiveness of enteral feeding protocol on clinical outcomes in critically ill patients : a study protocol for before-and-after design. 2016;4(16):1-10. doi: 10.21037/atm.2016.07.15
Leis C, Arthur AE, Chen X, Greene MW, Frug AD. Systematic Review of Nutrition Interventions to Improve Short Term Outcomes in Head and Neck Cancer Patients. Published online 2023:1-12.
Gonçalves TJM, Carlos BT, de Souza MS, et al. Effects of an Oral Nutritional Supplementation and Physical Exercise Intervention on Older Adults at Risk for Sarcopenia. J frailty, sarcopenia falls. 2024;9(3):184-191. doi: 10.22540/JFSF-09-184
Cramer JT, Cruz-Jentoft AJ, Landi F, et al. Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial. J Am Med Dir Assoc. 2016;17(11):1044-1055. doi:10.1016/j.jamda.2016.08.009
Chew STH, Tan NC, Cheong M, et al. Impact of specialized oral nutritional supplement on clinical, nutritional, and functional outcomes: A randomized, placebo-controlled trial in community-dwelling older adults at risk of malnutrition. Clin Nutr. 2021;40(4):1879-1892. doi:10.1016/j.clnu.2020.10.015
Matheson EM, Nelson JL, Baggs GE, Luo M, Deutz NE. Specialized oral nutritional supplement (ONS) improves handgrip strength in hospitalized, malnourished older patients with cardiovascular and pulmonary disease: A randomized clinical trial. Clin Nutr. 2021;40(3):844-849. doi:10.1016/j.clnu.2020.08.035
Quattrocchi A, Garufi G, Gugliandolo G, et al. Handgrip Strength in Health Applications: A Review of the Measurement Methodologies and Influencing Factors. Sensors. 2024;24(16). doi:10.3390/s24165100
Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc. 2020;21(3):300-307.e2. doi:10.1016/j.jamda.2019.12.012
Jannah IN, Suhartono S, Adi MS. Prevalensi phlebitis pada pasien rawat inap dengan infus di RSUD Tugurejo Semarang. J Kesehat Masy. 2016;4(4):943-949.
Kaegi-braun N, Tribolet P, Baumgartner A, et al. Value of handgrip strength to predict clinical outcomes and therapeutic response in malnourished medical inpatients : Secondary analysis of a randomized controlled trial. Am J Clin Nutr. 2021;114(2):731-740. doi:10.1093/ajcn/nqab042
López-Medina JA, López-Rodriguez C, Estornell-Gualde MA, et al. Relationship between nutritional treatment compliance and nutritional status improvements in patients with gastrointestinal impairment taking an oral peptide-based supplement. Nutrition. 2022;102:111734. doi:10.1016/j.nut.2022.111734
Pedrianes-Martin PB, Dassen-de-Monzo C, Guardia-Baena JM, et al. Physicians’ Perception of Oral Nutritional Supplement Acceptance and Tolerability in Malnourished Outpatients: PerceptiONS Study. Nutrients. 2023;15(5). doi:10.3390/nu15051219
Baggs GE, Middleton C, Nelson JL, et al. Impact of a specialized oral nutritional supplement on quality of life in older adults following hospitalization: Post-hoc analysis of the NOURISH trial. Clin Nutr. 2023;42(11):2116-2123. doi:10.1016/j.clnu.2023.09.004
Gomez G, Botero-Rodríguez F, Misas JD, et al. A nutritionally focused program for community-living older adults resulted in improved health and well-being. Clin Nutr. 2022;41(7):1549-1556. doi:10.1016/j.clnu.2022.05.003
Dewi EU, Widari NP. Faktor Yang Mempengaruhi Kualitas Hidup Pasien Kanker Pada Masa Pandemi Covid-19 Di Yayasan Kanker Indonesia Surabaya. J Keperawatan. 2021;10(2):10-19. doi:10.47560/kep.v10i2.289
Hong E. Health-related quality of life and health condition of community-dwelling populations with cancer, stroke, and cardiovascular disease. J Phys Ther Sci. 2015;27(8):2521-2524. doi:10.1589/jpts.27.2521
McGorrian C, McShane C, McQuade C, et al. Family-based associations in measures of psychological distress and quality of life in a cardiac screening clinic for inheritable cardiac diseases: a cross-sectional study. BMC Med Genet. 2013;14:1. doi:10.1186/1471-2350-14-1
Hsu NW, Tsao HM, Chen HC, Chou P. Anxiety and depression mediate the health-related quality of life differently in patients with cardiovascular disease and stroke-preliminary report of the Yilan study: A population-based community health survey. PLoS One. 2014;9(9). doi:10.1371/journal.pone.0107609
BAPEN. Oral Nutritional Supplements (ONS). 2025. https://www.bapen.org.uk/education/nutrition-support/nutrition-by-mouth/oral-nutritional-supplements-ons/
Ratni E, Lendrawati, Arief. The evolving landscape of milk consumption in Indonesia amidst the rise of contemporary beverages. IOP Conf Ser Earth Environ Sci. 2024;1341(1):12114. doi:10.1088/1755-1315/1341/1/012114