Hospital Pharmacist
2006;13:353-358
November 2006

Undernutrition in hospital — causes and consequences

By Pamela Mason, PhD, MRPharmS

Malnutrition refers to both undernutrition and obesity. Pharmacists should be aware of the high incidence of undernutrition in hospital patients and how they can contribute to detecting this problem. This article describes the relationship between undernutrition and medicines

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SUMMARY

Malnutrition is a common but frequently ignored problem in hospital patients. Symptoms of malnutrition may go unnoticed or may be mistaken for those of the patient’s main illness. Furthermore, nutritional status is frequently unrecorded in the patient’s medical notes. However, if a patient is malnourished and no attention is paid to nutritional intake, disease prognosis is likely to be poor, hospital stay lengthened and the patient may be less able to respond to surgical and medical procedures, including medication, thus increasing the risk of therapeutic failure and adverse effects.

In addition, hospital malnutrition costs the NHS a considerable sum of money. Of the total cost of treating malnutrition in the UK, which is in excess of £7.3 billion (and more than double the projected £3.5 billion cost of obesity), more than half arises from the treatment of malnourished patients in hospital (approximately £3.8 billion) and in long-term care facilities (approximately £2.6 billion). The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Acute Care have produced a clinical guideline on treatment of malnutrition. Although pharmacists are not usually involved in nutritional assessment, they should be aware of the high incidence of malnutrition in hospitals and of the contribution they can make to the detection and management of this important public health problem.