2020 Volume 23 Issue 2 Pages 74-78
Purpose: To evaluate the effects of dietary intervention by registered dietitians (RDs) for patients admitted to the palliative care unit (PCU). Methods: We retrospectively reviewed the clinical records of patients who were admitted to the PCU between October 1, 2019 and March 31, 2020. For patients who were able to eat and express their will, RDs participated in the staff meeting at admission and visited the patients’ bedside to arrange their daily diet. Results: A total of 49 patients were examined. All patients were transferred to the PCU from acute care wards in our hospital and the median duration of PCU stay was 11 days (range, 1–48 days). Of the 49 patients, no RD visit was recorded for 23 whose median duration of PCU stay was 8 days (range, 11–32 days). Their dietary energy intake at admission ranged between 0 to 725 kilocalories per day (kcal/day), with a median value of 0 kcal/day. No patient had an increase in energy by 100 kcal/day or more during the PCU stay. On the other hand, the remaining 26 patients were visited by RDs on the day of admission (23 patients [88.4%]) or 4–11 days after admission (3 patients). The median duration of PCU stay was 16 days (range, 2–48 days) and the median dietary energy intake at admission was 365 kcal/day (range, 0–1,305 kcal). In total, they received dietary intervention by RDs 57 times: once for 14 (53.8%) patients, twice for 2, and 3 times or more for 10. Of note, 6 (20.7%) of the 26 patients had an increase in dietary energy intake by 100 kcal/day or more during the PCU stay and this effect was significant compared with the non-intervention group (Fisher’s exact test, P = 0.024). Conclusion: More than half of the PCU patients whose nutritional states were generally impaired received dietary intervention by RDs and a significant fraction had an increase in dietary energy intake during their PCU stay. Currently, dietary intervention by RDs in PCUs is not remunerated; however, we recommend that these activities be acknowledged and formally covered by the medical service fee system.
