Home parenteral nutrition: Outcome and seven year prospective follow up in a nationwide adult population

In Scotland, an important opportunity is provided to review long-term survival and Home Parenteral Nutrition (HPN) dependence across an entire population by the existence of the Scottish HPN Managed Clinical Network (MCN). Through the existence of the MCN, we are able to report the survival rates and outcomes of HPN patients across Scotland as a whole, where treatment is delivered locally under nationally agreed guidelines: The study aims to establish whether this population of adult patients behave in a similar way to previously reported groups in terms of survival, prognostic factors and HPN dependence. All patient data has been entered prospectively since commencement of their parenteral nutrition. The overall survival probability after starting HPN for the 136 patients studied was 86.0% at 1 year, 78.7% at 3 years, 77.2% at 5 years and 76.5% at 6 years. In this study, dependence on HPN was 61%, 51% and 48% at 1, 3 and 5 years. No difference was found between survival in patients treated at two of Scotland’s largest HPN centres and the smaller centres treating far fewer patients. Indications for HPN are similar to those reported in UK literature. Our outcomes are similar to those reported from large specialist centres, supporting the value of managed networks in maintaining quality of patient care across our wide geographical area and resulting diverse demographic.