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Reduction in Healthcare Utilization With Transition to Peptide‐Based Diets in Intolerant Home Enteral Nutrition Patients
Author(s) -
Mundi Manpreet S.,
Velapati Saketh,
Kuchkuntla Aravind R.,
Hurt Ryan T.
Publication year - 2020
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1002/ncp.10477
Subject(s) - medicine , nausea , percutaneous endoscopic gastrostomy , vomiting , diarrhea , parenteral nutrition , enteral administration , abdominal pain , retrospective cohort study , population , health care , emergency medicine , environmental health , finance , peg ratio , economics , economic growth
Background Since the introduction of percutaneous endoscopic gastrostomy in the 1980s, the prevalence of home enteral nutrition (HEN) support has increased significantly. Despite these increases, many patients are unable to tolerate standard polymeric formulas (SPFs), resulting in significant healthcare resource utilization. Peptide‐based diets (PBDs) have emerged as a viable option in SPF‐intolerant patients; however, data in the HEN population are lacking. Methods Retrospective review of our prospectively maintained HEN database was conducted to assess tolerance, efficacy, and impact on healthcare utilization in patients on PBDs. Results From January 1, 2016, to May 1, 2018, 95 patients were placed on PBDs, with 53 patients being started directly and 42 patients being transitioned from SPFs. In patients transitioned to PBDs, symptoms of nausea and vomiting, diarrhea, abdominal pain, and distention improved significantly. Healthcare utilization also declined significantly, including mean number of phone calls (1.8 ± 1.6 to 1.1 ± 0.9, P = 0.006), mean number of emergency room visits (0.3 ± 0.6 to 0.09 ± 0.3, P = 0.015), and mean number of provider visits (1.3 ± 1.3 to 0.3 ± 0.5, P < 0.0001). Conclusions Overall, PBDs were well tolerated and resulted in significant improvements in symptoms of gastrointestinal distress and healthcare utilization in patients intolerant to SPFs.