Study Evaluates 203 Home Enteral Nutrition (HEN) Patients

Klek S, Szybinski P, Sierzega M, et al. Commercial enteral formulas and nutrition support teams improve the outcome of home enteral tube feeding. JPEN. 2011;3:380-385. (The authors are from Krakow, Poland. Some of the authors are employed by Nutrimed Medical Corporation.)

This was an interesting study evaluating 203 home enteral nutrition (HEN) patients. To start, the patients were fed homemade diets (pureed table foods) for tube feeding for 12 months, with oversight by the family only. Following use of the homemade diets, the patients used commercial enteral tube feeding (ETF) for 12 months, with the guidance of a nutritional support team (NST). When the patients used the ETF with the guidance of an NST, as compared to when they used a homemade tube feeding with no NST, they had significantly reduced hospital admissions (0.21/year [p<.001] vs. 1.2/year), duration of hospitalizations (3.83 days [p<.001] versus 20.84 days), and duration of ICU stay (0.50 days [p<.001] versus 2.35 days). Also, the cost of hospitalization was significantly reduced in the commercial ETF group that was followed by an NST. In addition, the incidence of pneumonia, respiratory failure, urinary tract infection, and anemia were significantly reduced in the commercial ETF/NST oversight group (p<.05).

This study used the same patients for their own controls, thus creating a very good comparison study. Often when evaluating the use of a medical product, we look at the cost of the intervention only. In this case, the use of commercial tube feeding and NST guidance was most likely more costly initially than pureed table foods and oversight only by the family. However, the use of commercial ETF and NST guidance led to significantly improved clinical outcomes and a significant reduction in the cost of hospitalization. This study shows that tube feeding at home is not an intervention that should be viewed as “secondary” to the other therapies the patient may be receiving. Proper use of HEN can significantly impact patient clinical outcomes.