A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings
Summary Background & aims Despite the clinical benefits of using standard (non-disease specific) oral nutritional supplements (ONS) in the community and care homes, there is uncertainty about their economic consequences. Methods A systematic review was undertaken according to recommended procedu...
Gespeichert in:
| Veröffentlicht in: | Clinical nutrition (Edinburgh, Scotland) Scotland), 2016-02, Vol.35 (1), p.125-137 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 137 |
|---|---|
| container_issue | 1 |
| container_start_page | 125 |
| container_title | Clinical nutrition (Edinburgh, Scotland) |
| container_volume | 35 |
| creator | Elia, M Normand, C Laviano, A Norman, K |
| description | Summary Background & aims Despite the clinical benefits of using standard (non-disease specific) oral nutritional supplements (ONS) in the community and care homes, there is uncertainty about their economic consequences. Methods A systematic review was undertaken according to recommended procedures to assess whether ONS can produce cost savings and cost-effective outcomes. Results 19 publications with and without a hospital component were identified: 9 full text papers, 9 abstracts, and 1 report with retrospective analyses of 6 randomised controlled trials. From these publications a total of 31 cost and 4 cost-effectiveness analyses were identified. Most were retrospective analyses based on clinical data from randomised controlled trials (RCTs). In 9 studies/economic models involving ONS use for |
| doi_str_mv | 10.1016/j.clnu.2015.07.012 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1764338103</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0261561415001910</els_id><sourcerecordid>1764338103</sourcerecordid><originalsourceid>FETCH-LOGICAL-c521t-ea3acb8a4b13767c9de6d340db5a38beb46bd1a601a1389b3430eb2608f896723</originalsourceid><addsrcrecordid>eNp9kr2O1TAQhS0EYi8LL0CBXNIkjO3ESSSEtFrxJ61EAdSW40xYXxLn4nEW3UfgrXGUhYKCaqY455PmnGHsuYBSgNCvjqWbwlpKEHUJTQlCPmAHUStZiK5VD9kBpBZFrUV1wZ4QHQGgVk37mF1IraCTFRzYrytOZ0o42-Qdj3jn8SdfRp5ukbuFErdh2BccR3TJ32FAok2ykg_fOKWssHHgS7QTD2uKPvkl5J3W02nCGUMi7kOGzPMafDrvSBuR3y4zcsKUMoieskejnQif3c9L9vXd2y_XH4qbT-8_Xl_dFK6WIhVolXV9a6teqEY3rhtQD6qCoa-tanvsK90PwmoQVqi261WlAHupoR3bTjdSXbKXO_cUlx8rUjKzJ4fTZAMuKxnR6EqpVoDKUrlLXVyIIo7mFP1s49kIMFsF5mi2CsxWgYHG5Aqy6cU9f-1nHP5a_mSeBa93AeYrc97RkPMYHA4-5oTNsPj_89_8Y3eTD97Z6TuekY7LGnP6-Q5D0oD5vD3B9gOiBhBdPus340Svdg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1764338103</pqid></control><display><type>article</type><title>A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Elia, M ; Normand, C ; Laviano, A ; Norman, K</creator><creatorcontrib>Elia, M ; Normand, C ; Laviano, A ; Norman, K</creatorcontrib><description>Summary Background & aims Despite the clinical benefits of using standard (non-disease specific) oral nutritional supplements (ONS) in the community and care homes, there is uncertainty about their economic consequences. Methods A systematic review was undertaken according to recommended procedures to assess whether ONS can produce cost savings and cost-effective outcomes. Results 19 publications with and without a hospital component were identified: 9 full text papers, 9 abstracts, and 1 report with retrospective analyses of 6 randomised controlled trials. From these publications a total of 31 cost and 4 cost-effectiveness analyses were identified. Most were retrospective analyses based on clinical data from randomised controlled trials (RCTs). In 9 studies/economic models involving ONS use for <3 months, there were consistent cost savings compared to the control group (median cost saving 9.2%; P < 0.01). When used for ≥3 months, the median cost saving was 5% (P > 0.05; 5 studies). In RCTs, ONS accounted for less than 5% of the total costs and the investment in the community produced a cost saving in hospital. Meta-analysis indicated that ONS reduced hospitalisation significantly (16.5%; P < 0.001; 9 comparisons) and mortality non-significantly (Relative risk 0.86 (95% CI, 0.61, 1.22); 8 comparisons). Many clinically relevant outcomes favouring ONS were reported: improved quality of life, reduced infections, reduced minor post-operative complications, reduced falls, and functional limitations. Of the cost-effectiveness analyses involving quality adjusted life years or functional limitations, most favoured the ONS group. The care home studies (4 cost analyses; 2 cost-effectiveness analyses) had differing aims, designs and conclusions. Conclusions Overall, the reviewed studies, mostly based on retrospective cost analyses, indicate that ONS use in the community produce an overall cost advantage or near neutral balance, often in association with clinically relevant outcomes, suggesting cost effectiveness. There is a need for prospective studies designed to examine primary economic outcomes.</description><identifier>ISSN: 0261-5614</identifier><identifier>EISSN: 1532-1983</identifier><identifier>DOI: 10.1016/j.clnu.2015.07.012</identifier><identifier>PMID: 26309240</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Community ; Cost ; Cost effectiveness ; Cost-Benefit Analysis ; Databases, Factual ; Dietary Supplements - economics ; Gastroenterology and Hepatology ; Hospitalization ; Humans ; Malnutrition ; Malnutrition - economics ; Malnutrition - prevention & control ; Micronutrients - administration & dosage ; Micronutrients - economics ; Oral nutritional supplements ; Quality of Life ; Quality-Adjusted Life Years ; Randomized Controlled Trials as Topic ; Systematic review</subject><ispartof>Clinical nutrition (Edinburgh, Scotland), 2016-02, Vol.35 (1), p.125-137</ispartof><rights>The Authors</rights><rights>2015 The Authors</rights><rights>Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-ea3acb8a4b13767c9de6d340db5a38beb46bd1a601a1389b3430eb2608f896723</citedby><cites>FETCH-LOGICAL-c521t-ea3acb8a4b13767c9de6d340db5a38beb46bd1a601a1389b3430eb2608f896723</cites><orcidid>0000-0002-9809-3553</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0261561415001910$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26309240$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elia, M</creatorcontrib><creatorcontrib>Normand, C</creatorcontrib><creatorcontrib>Laviano, A</creatorcontrib><creatorcontrib>Norman, K</creatorcontrib><title>A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings</title><title>Clinical nutrition (Edinburgh, Scotland)</title><addtitle>Clin Nutr</addtitle><description>Summary Background & aims Despite the clinical benefits of using standard (non-disease specific) oral nutritional supplements (ONS) in the community and care homes, there is uncertainty about their economic consequences. Methods A systematic review was undertaken according to recommended procedures to assess whether ONS can produce cost savings and cost-effective outcomes. Results 19 publications with and without a hospital component were identified: 9 full text papers, 9 abstracts, and 1 report with retrospective analyses of 6 randomised controlled trials. From these publications a total of 31 cost and 4 cost-effectiveness analyses were identified. Most were retrospective analyses based on clinical data from randomised controlled trials (RCTs). In 9 studies/economic models involving ONS use for <3 months, there were consistent cost savings compared to the control group (median cost saving 9.2%; P < 0.01). When used for ≥3 months, the median cost saving was 5% (P > 0.05; 5 studies). In RCTs, ONS accounted for less than 5% of the total costs and the investment in the community produced a cost saving in hospital. Meta-analysis indicated that ONS reduced hospitalisation significantly (16.5%; P < 0.001; 9 comparisons) and mortality non-significantly (Relative risk 0.86 (95% CI, 0.61, 1.22); 8 comparisons). Many clinically relevant outcomes favouring ONS were reported: improved quality of life, reduced infections, reduced minor post-operative complications, reduced falls, and functional limitations. Of the cost-effectiveness analyses involving quality adjusted life years or functional limitations, most favoured the ONS group. The care home studies (4 cost analyses; 2 cost-effectiveness analyses) had differing aims, designs and conclusions. Conclusions Overall, the reviewed studies, mostly based on retrospective cost analyses, indicate that ONS use in the community produce an overall cost advantage or near neutral balance, often in association with clinically relevant outcomes, suggesting cost effectiveness. There is a need for prospective studies designed to examine primary economic outcomes.</description><subject>Community</subject><subject>Cost</subject><subject>Cost effectiveness</subject><subject>Cost-Benefit Analysis</subject><subject>Databases, Factual</subject><subject>Dietary Supplements - economics</subject><subject>Gastroenterology and Hepatology</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Malnutrition</subject><subject>Malnutrition - economics</subject><subject>Malnutrition - prevention & control</subject><subject>Micronutrients - administration & dosage</subject><subject>Micronutrients - economics</subject><subject>Oral nutritional supplements</subject><subject>Quality of Life</subject><subject>Quality-Adjusted Life Years</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Systematic review</subject><issn>0261-5614</issn><issn>1532-1983</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kr2O1TAQhS0EYi8LL0CBXNIkjO3ESSSEtFrxJ61EAdSW40xYXxLn4nEW3UfgrXGUhYKCaqY455PmnGHsuYBSgNCvjqWbwlpKEHUJTQlCPmAHUStZiK5VD9kBpBZFrUV1wZ4QHQGgVk37mF1IraCTFRzYrytOZ0o42-Qdj3jn8SdfRp5ukbuFErdh2BccR3TJ32FAok2ykg_fOKWssHHgS7QTD2uKPvkl5J3W02nCGUMi7kOGzPMafDrvSBuR3y4zcsKUMoieskejnQif3c9L9vXd2y_XH4qbT-8_Xl_dFK6WIhVolXV9a6teqEY3rhtQD6qCoa-tanvsK90PwmoQVqi261WlAHupoR3bTjdSXbKXO_cUlx8rUjKzJ4fTZAMuKxnR6EqpVoDKUrlLXVyIIo7mFP1s49kIMFsF5mi2CsxWgYHG5Aqy6cU9f-1nHP5a_mSeBa93AeYrc97RkPMYHA4-5oTNsPj_89_8Y3eTD97Z6TuekY7LGnP6-Q5D0oD5vD3B9gOiBhBdPus340Svdg</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Elia, M</creator><creator>Normand, C</creator><creator>Laviano, A</creator><creator>Norman, K</creator><general>Elsevier Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9809-3553</orcidid></search><sort><creationdate>20160201</creationdate><title>A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings</title><author>Elia, M ; Normand, C ; Laviano, A ; Norman, K</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-ea3acb8a4b13767c9de6d340db5a38beb46bd1a601a1389b3430eb2608f896723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Community</topic><topic>Cost</topic><topic>Cost effectiveness</topic><topic>Cost-Benefit Analysis</topic><topic>Databases, Factual</topic><topic>Dietary Supplements - economics</topic><topic>Gastroenterology and Hepatology</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Malnutrition</topic><topic>Malnutrition - economics</topic><topic>Malnutrition - prevention & control</topic><topic>Micronutrients - administration & dosage</topic><topic>Micronutrients - economics</topic><topic>Oral nutritional supplements</topic><topic>Quality of Life</topic><topic>Quality-Adjusted Life Years</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elia, M</creatorcontrib><creatorcontrib>Normand, C</creatorcontrib><creatorcontrib>Laviano, A</creatorcontrib><creatorcontrib>Norman, K</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elia, M</au><au>Normand, C</au><au>Laviano, A</au><au>Norman, K</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings</atitle><jtitle>Clinical nutrition (Edinburgh, Scotland)</jtitle><addtitle>Clin Nutr</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>35</volume><issue>1</issue><spage>125</spage><epage>137</epage><pages>125-137</pages><issn>0261-5614</issn><eissn>1532-1983</eissn><abstract>Summary Background & aims Despite the clinical benefits of using standard (non-disease specific) oral nutritional supplements (ONS) in the community and care homes, there is uncertainty about their economic consequences. Methods A systematic review was undertaken according to recommended procedures to assess whether ONS can produce cost savings and cost-effective outcomes. Results 19 publications with and without a hospital component were identified: 9 full text papers, 9 abstracts, and 1 report with retrospective analyses of 6 randomised controlled trials. From these publications a total of 31 cost and 4 cost-effectiveness analyses were identified. Most were retrospective analyses based on clinical data from randomised controlled trials (RCTs). In 9 studies/economic models involving ONS use for <3 months, there were consistent cost savings compared to the control group (median cost saving 9.2%; P < 0.01). When used for ≥3 months, the median cost saving was 5% (P > 0.05; 5 studies). In RCTs, ONS accounted for less than 5% of the total costs and the investment in the community produced a cost saving in hospital. Meta-analysis indicated that ONS reduced hospitalisation significantly (16.5%; P < 0.001; 9 comparisons) and mortality non-significantly (Relative risk 0.86 (95% CI, 0.61, 1.22); 8 comparisons). Many clinically relevant outcomes favouring ONS were reported: improved quality of life, reduced infections, reduced minor post-operative complications, reduced falls, and functional limitations. Of the cost-effectiveness analyses involving quality adjusted life years or functional limitations, most favoured the ONS group. The care home studies (4 cost analyses; 2 cost-effectiveness analyses) had differing aims, designs and conclusions. Conclusions Overall, the reviewed studies, mostly based on retrospective cost analyses, indicate that ONS use in the community produce an overall cost advantage or near neutral balance, often in association with clinically relevant outcomes, suggesting cost effectiveness. There is a need for prospective studies designed to examine primary economic outcomes.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26309240</pmid><doi>10.1016/j.clnu.2015.07.012</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-9809-3553</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0261-5614 |
| ispartof | Clinical nutrition (Edinburgh, Scotland), 2016-02, Vol.35 (1), p.125-137 |
| issn | 0261-5614 1532-1983 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1764338103 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Community Cost Cost effectiveness Cost-Benefit Analysis Databases, Factual Dietary Supplements - economics Gastroenterology and Hepatology Hospitalization Humans Malnutrition Malnutrition - economics Malnutrition - prevention & control Micronutrients - administration & dosage Micronutrients - economics Oral nutritional supplements Quality of Life Quality-Adjusted Life Years Randomized Controlled Trials as Topic Systematic review |
| title | A systematic review of the cost and cost effectiveness of using standard oral nutritional supplements in community and care home settings |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-21T20%3A01%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20systematic%20review%20of%20the%20cost%20and%20cost%20effectiveness%20of%20using%20standard%20oral%20nutritional%20supplements%20in%20community%20and%20care%20home%20settings&rft.jtitle=Clinical%20nutrition%20(Edinburgh,%20Scotland)&rft.au=Elia,%20M&rft.date=2016-02-01&rft.volume=35&rft.issue=1&rft.spage=125&rft.epage=137&rft.pages=125-137&rft.issn=0261-5614&rft.eissn=1532-1983&rft_id=info:doi/10.1016/j.clnu.2015.07.012&rft_dat=%3Cproquest_cross%3E1764338103%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1764338103&rft_id=info:pmid/26309240&rft_els_id=S0261561415001910&rfr_iscdi=true |