GPs urged to tackle malnutrition

Malnutrition is a common and expensive problem, and 93% of the 3 million people affected are living in the community, say the authors of a new report. They have published a new practical guide, endorsed by the RCGP, to help GPs to identify and manage patients at risk of malnutrition.

The report found that one in ten GP patients is malnourished – and disease, rather than poverty, is the principal cause. At-risk groups include people with dementia, cancer, those recently discharged from hospital and those suffering acute illness.

Disease-related malnutrition has been calculated to contribute more than £13bn a year to public health expenditure, and suffers cost the NHS more than twice as much to treat as those who are not malnourished. Its clinical consequences include:

• impaired immune response
• reduced muscle strength
• impaired wound healing
• impaired psychosocial function
• impaired recovery from illness and surgery
• poorer clinical outcomes.

NICE says that new patients should be screened for malnutrition on registration, and then those in at risk groups should be screened annually. The new practical guide explains how to use the malnutrition universal screening tool (MUST) that NICE recommends, and advises how to help patients improve their oral dietary intake. It also includes a pathway that shows when and how to use oral nutritional supplements (ONS).

One of the document’s developers, RCGP clinical champion for nutrition for health Dr Rachel Pryke, said: “I’m sure many people will be surprised to hear that in the 21st century a western nation like Britain could have so many people at risk of malnutrition. 

GPs are well-placed to make a huge difference to the lives of these people. With an ageing population many of the risks associated with malnutrition are also going to increase.

“We can help reduce these risks by ensuring that GPs and their teams are well-versed in spotting the signs of malnutrition and managing appropriately to improve clinical and health economic outcomes in what can be an avoidable issue.”

More information, and the MUST guide and ONS pathway, are available through the ‘Managing Adult Malnutrition in the Community’ website.