Should handgrip strength be considered when choosing the administration mode of oral nutritional supplements in geriatric patients? - A secondary analysis of the MEDPass Trial

Objective To individualize nutrition therapy, it is relevant to identify whether certain patient groups benefit better from a specific intervention such as oral nutritional supplements (ONS). The aim of this study was to investigate if patients with weak handgrip strength (HGS) benefit better from ONS administration in the MEDPass mode regarding the individual coverage of energy and protein requirements throughout their hospitalization. Research Methods & Procedures A secondary analysis of the intention to treat dataset of the randomized controlled MEDPass Trial was conducted. Weak HGS was defined as <27.0 kg for men and <16.0 kg for women. Linear mixed effect models adjusted for the stratification factors energy density of ONS and NRS 2002 score were used to address the aim of the study. Results 188 participants were included. Energy and protein coverage did not differ between the patients with weak or normal HGS depending on ONS administration mode (p = 0.084, p = 0.108). Patients with weak HGS and MEDPass administration mode tend to have the lowest energy and protein coverage (estimated mean [95% CI] 77.2% [69.3%-85.0%] and 95.1% [85.3%-105%], respectively). Patients with weak HGS and conventional ONS administration tend to have the highest energy and protein coverage (estimated mean [95% CI] 90.0% [82.8%-97.2%] and 110.2% [101.3%-119%], respectively). Conclusion No clear recommendations regarding the mode of ONS administration depending on HGS can be made. In clinical practice, appetite and satiety in patients with weak HGS should be monitored and the ONS administration mode should be adjusted accordingly.