Effect of Medically Tailored Meals on Clinical Outcomes in Recently Hospitalized High-Risk Adults

Dados Bibliográficos

ID9101473
AutoresAlan S Go (0000-0001-9109-0811, Kaiser Permanente Northern California, autor correspondente), Thida C Tan (Kaiser Permanente Northern California, autor correspondente), Kate M Horiuchi (Kaiser Permanente Northern California, autor correspondente), Denise Laws (Kaiser Permanente Santa Rosa Medical Center, Santa Rosa), Andrew P Ambrosy (0000-0002-4563-1071, Kaiser Permanente Northern California, autor correspondente), Keane K Lee (0000-0002-3650-1750, Kaiser Permanente Northern California, autor correspondente), Benjamin L Maring (Department of Internal Medicine, Kaiser Permanente Oakland Medical Center, Oakland), B Maring (Kaiser Permanente Oakland Medical Center, autor correspondente), Jena Joy (Department of Internal Medicine, Kaiser Permanente Oakland Medical Center, Oakland, autor correspondente), Cathryn Couch (Ceres Community Project, Sebastopol), Paul Hepfer (Project Open Hand, San Francisco), Joan C Lo (0000-0002-7159-0648, Kaiser Permanente Northern California, autor correspondente), Rishi V Parikh (Kaiser Permanente Northern California), Rishi Parikh (0000-0002-1115-844X, Kaiser Permanente, autor correspondente), for the KP NOURISH Study Investigators (Apple (Israel))
Ano2022
Volume60
Fascículo10
Páginas750-758
Data de publicação2022-10-01
Open AccessSim
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001759
PMID35972131
OpenAlexW4292185161
IdiomaEN
Citações recebidas2
Referências citadas30

BACKGROUND: Inability to adhere to nutritional recommendations is common and linked to worse outcomes in patients with nutrition-sensitive conditions. OBJECTIVES: The purpose of this study is to evaluate whether medically tailored meals (MTMs) improve outcomes in recently discharged adults with nutrition-sensitive conditions compared with usual care. RESEARCH DESIGN: Remote pragmatic randomized trial. SUBJECTS: Adults with heart failure, diabetes, or chronic kidney disease being discharged home between April 27, 2020, and June 9, 2021, from 5 hospitals within an integrated health care delivery system. MEASURES: Participants were prerandomized to 10 weeks of MTMs (with or without virtual nutritional counseling) compared with usual care. The primary outcome was all-cause hospitalization within 90 days after discharge. Exploratory outcomes included all-cause and cause-specific health care utilization and all-cause death within 90 days after discharge. RESULTS: A total of 1977 participants (MTMs: n=993, with 497 assigned to also receive virtual nutritional counseling; usual care: n=984) were enrolled. Compared with usual care, MTMs did not reduce all-cause hospitalization at 90 days after discharge [adjusted hazard ratio, aHR: 1.02, 95% confidence interval (CI), 0.86-1.21]. In exploratory analyses, MTMs were associated with lower mortality (aHR: 0.65, 95% CI, 0.43-0.98) and fewer hospitalizations for heart failure (aHR: 0.53, 95% CI, 0.33-0.88), but not for any emergency department visits (aHR: 0.95, 95% CI, 0.78-1.15) or diabetes-related hospitalizations (aHR: 0.75, 95% CI, 0.31-1.82). No additional benefit was observed with virtual nutritional counseling. CONCLUSIONS: Provision of MTMs after discharge did not reduce risk of all-cause hospitalization in adults with nutrition-sensitive conditions. Additional large-scale randomized controlled trials are needed to definitively determine the impact of MTMs on survival and cause-specific health care utilization in at-risk individuals

Intensive care medicine · MEDLINE · Food Security and Health in Diverse Populations · Medicine · Nutrition and Health in Aging · Obesity and Health Practices