Compliance of orthopaedic patients with postoperative oral nutritional supplementation

Background: Studies have shown clinical benefits of nutritional supplementation in orthopaedic and elderly patients in both under and well nourished groups. However, patient compliance with the supplementation has not been reported. Aim: To assess level of patient compliance with nutritional supplementation when prescribed postoperatively to unselected orthopaedic patients as part of a large controlled trial researching the clinical benefits of non-targeted nutritional supplementation. Methods: Patients in the intervention group were prescribed two oral supplements each day of their hospital stay, in addition to usual meals. Information describing the supplements was given by the dietitian. Supplements were issued on drug rounds and the proportion of each drink consumed was recorded and collated. Patients could choose to change the type of drink or to discontinue the supplements completely at any time. Twenty-four hour food intake was analysed for a random sub-sample of 48 patients. Results: Eighty-four patients (27 men, 57 women; mean age, 72 years) were prescribed supplements. Median length of stay was 14.4 days. Supplements were taken for a mean of 6.7 days. Median compliance was 14.9%. Despite this, median energy intake in the study group was 1523 kcal/day and 1289 kcal/day in the control (P = 0.0214). Conclusion: Compliance with non-targeted, postoperative nutritional supplementation is poor in unselected orthopaedic patients but even low levels of supplementation significantly increase energy intake. (C) 2000 Harcourt Publishers Ltd.