¿Podemos integrar la atención nutricional en los distintos niveles asistenciales? Reflexiones desde la cronicidad y la complejidad clínica

Nowadays, chronicity is the leitmotiv in all healthcare systems. Consequently, multimorbidity and the management of complex care needs become a critical challenge in modern welfare societies. Professionals and other agents’ difficulties to identify and satisfy healthcare related needs of these patients is especially signifi cant in a 5% of the population. This has an enormous impact not only from a clinical perspective, but also in terms of the resilience of public health care systems. In this context, nutritional status plays an outstanding role as a health indicator and also as a determinant vector of morbidity and mortality. However, improvement possibilities regarding the evolution of epidemiological knowledge and the implementation of person-centered attention models are still vast. The management of malnutrition related to complex chronic conditions is not limited to the profi le of the patient’s conditions, since the explanatory role of social factors, which become key to clinical management, is crucial. As a result of the above, integrated and person-centered approaches, where nutritional factors often play an important role, are required to provide care to the most vulnerable patients within our settings. Therefore, collaborative work appears as one of the keys to success.