Article Figures & Data
Figures
- Figure 1. Percentage of oral nutritional supplements (ONS) product type dispensed to long-term ONS users (n = 912) as per Supplementary Table 2. CHO = Community Health Organisation.
- Figure 2. Percentage of oral nutritional supplements (ONS) product type dispensed to ONS long-term users (n = 912), segregated by patient age category. (P<0.001).
Tables
Characteristic Individuals on ONS, n = 912 % Median (range) Sex Male 43.5 Female 56.5 Age 76 (18 to 101) ≥18 to 44 years 11.3 ≥45 to 64 years 21.8 ≥65 years 66.9 Area South/south east Dublin 16.0 West/south west Dublin 41.4 North/north west Dublin 42.5 Residential status Living in residential care 18.2 Living independently 81.7 Number of ONS products in 2018 1 (1 to 4) Number of ONS units in 2018 660 (12 to 3250) Patients on more than 1 ONS 10.0 Patients on ONS previous year 96.2 Number of medications 6.0 (0 to 18) Polypharmacy No polypharmacy (<5 drugs) 32.9 Polypharmacy (≥5 drugs) 45.6 Excessive polypharmacy (≥10) 21.5 Patient CNS drug dispensed a No CNS drug 24.8 CNS drug (<5 drugs) 65.9 CNS polypharmacy or excessive polypharmacy (≥5 drugs) 9.3 Patient circulatory drug dispensed b No circulatory drug 38.4 Circulatory drug (<5 drugs) 42.7 Circulatory polypharmacy or excessive polypharmacy (≥5 drugs) 19.0 GPs, n = 405 Sex Male 59.0 Female 41.0 Age 53 (33 to 72) ≥18 to 44 years 23.2 ≥45 to 64 years 61.5 ≥65 years 15.3 Area South/south east Dublin 23.2 West/south west Dublin 35.1 North/north west Dublin 39.3 Otherc 2.5 Number of patients on ONS 2 (1 to 17) GPs with > 2 patients on ONS 27.9 aCNS medication include drugs to treat anxiety; insomnia; psychoses; mood disorders; obsessive compulsive disorder; nausea; vomiting; vertigo; epilepsy and seizures; Parkinson's; Alzheimer's; multiple sclerosis; attention deficit hyperactivity disorder, and narcolepsy. bCirculatory medication include drugs to treat hypertension; oedema; heart failure; arrhythmias; angina; prevent myocardial infarction, stroke, and vascular events; hypercholesterolaemia; vascular diseases such as Raynaud's and pulmonary arterial hypertension; haemorrhage; anaemia and neutropenia. cA minority of patients attended GPs with practices in different areas to their residential area.
CNS = central nervous system. GP = general practitioner. ONS = oral nutritional supplements. PCERS = Primary Care and Eligibility Reimbursement Service.
Characteristic Median or % P value Living in privatenursing home Living independently Ag e, years ( n = 912) 87 (58 to 101) 71 (18 to 100) P<0.001 Sex Male 11.3 88.7 Female 23.7 76.3 P<0.001 Area ( n = 912) South/south east Dublin 17.4 15.7 West/south west Dublin 47.3 40.1 North/north west Dublin 35.3 44.2 P=0.110 Number of ONS units in 2018 ( n = 912 ) 600 (30 to 3192) 672 (12 to 3250) P=0.540 Patients on more than 1 ONS, n = 912 18.6 8.2 P<0.001 Patients on ONS previous year 92.8 96.9 P=0.023 Number of medications 7 (0 to 18) 6 (0 to 18) P=0.021 Polypharmacy No polypharmacy (<5 drugs) 21.0 35.6 Polypharmacy (≥5 drugs) 55.7 43.4 Excessive polypharmacy (≥10) 23.4 21.1 P=0.001 Patient CNS drug dispensed a No CNS drug 17.4 26.4 CNS drug (<5 drugs) 74.3 64.0 CNS polypharmacy or excessive polypharmacy (≥5 drugs) 8.4 9.5 P=0.032 Patient c irculatory drug dispensed b No circulatory drug 33.5 39.5 Circulatory drug (<5 drugs) 51.5 40.7 Circulatory drug polypharmacy or excessive polypharmacy (≥5 drugs) 15.0 19.9 P=0.035 aCNS medication include drugs to treat anxiety; Insomnia; psychoses; mood disorders; obsessive compulsive disorder; nausea; vomiting; vertigo; epilepsy and seizures; Parkinson's; Alzheimer's; multiple sclerosis; attention deficit hyperactivity disorder, and narcolepsy. bCirculatory medication include drugs to treat hypertension; oedema; heart failure; arrhythmias; angina; prevent myocardial infarction, stroke, and vascular events; hypercholesterolaemia; vascular diseases such as Raynaud's and pulmonary arterial hypertension; haemorrhage; anaemia and neutropenia.
CNS = central nervous system. ONS = oral nutritional supplements. PCERS = Primary Care and Eligibility Reimbursement Service.
- Table 3. Univariate analysis with characteristics of patients and GPs in the oral nutritional supplements (ONS) user and high ONS user groups
<660 ONS units ≥660 ONS units Characteristic n % n % P-value Patients S ex Male 181 45.6 216 54.4 Female 274 53.2 236 46.8 0.023 A r ea ( n = 912 ) South/south east Dublin 84 57.5 62 42.5 West/south west Dublin 184 48.7 194 51.3 North/north west Dublin 187 48.2 201 51.8 0.130 Residential status Living in a private nursing home 90 53.9 77 46.1 Living independently 365 49.0 380 51.0 0.270 A ge category ≥18 to 44 years 34 33.7 67 66.3 ≥45 to 64 years 63 31.7 136 68.3 ≥65 years 358 58.7 252 41.3 <0.001 Type of ONS a ONS type 1 239 45.7 284 54.3 ONS type 2 208 64.0 117 36.0 <0.001 G eneral p olypharmacy No polypharmacy (<5 drugs) 128 42.7 172 57.3 Polypharmacy (≥5 drugs) 222 53.4 194 46.6 Excessive polypharmacy (≥10 drugs) 105 53.6 91 46.4 0.009 CNS drug dispensed b No CNS drug 125 55.3 101 44.7 CNS drug (<5 drugs) 302 50.2 299 49.8 CNS polypharmacy or excessive polypharmacy (≥5 drugs) 28 32.9 57 67.1 0.002 C irculatory drug dispensed c No circulatory drug 146 41.7 204 58.3 Circulatory drug (<5 drugs) 207 53.2 182 46.8 Circulatory polypharmacy or excessive polypharmacy (≥5 drugs) 102 59.0 71 41.0 <0.001 GP s Sex Male 294 49.5 300 50.5 Female 161 50.6 157 49.4 0.781 A ge category ≥18 to 44 years 113 46.3 131 53.7 ≥45 to 64 years 263 51.8 245 48.2 ≥65 years 79 49.4 81 50.6 0.370 A rea South/south east Dublin 102 54.0 87 46.0 West/south west Dublin 161 49.1 167 50.9 North/north west Dublin 182 47.6 200 52.4 Other 10 76.9 3 23.1 0.116 aThis variable only includes those patients who were on one ONS type, ONS type 1 includes the two most common type of ONS as per Figure 2 (high energy and very high energy standard protein sip feed with or without fibre), ONS type 2 includes the other ONS types represented in Figure 2 (high energy shots, high protein sip feed, high energy semi-solid, textured modified high energy/high protein sip feeds). bCNS medication include drugs to treat anxiety; insomnia; psychoses; mood disorders; obsessive compulsive disorder; nausea; vomiting; vertigo; epilepsy and seizures; Parkinson's; Alzheimer's; multiple sclerosis; attention deficit hyperactivity disorder, and narcolepsy. cCirculatory medication include drugs to treat hypertension; oedema; heart failure; arrhythmias; angina; prevent myocardial infarction, stroke, and vascular events; hypercholesterolaemia; vascular diseases such as Raynaud's and pulmonary arterial hypertension; haemorrhage; anaemia and neutropenia.
CNS = central nervous system. GP = general practitioner. ONS = oral nutritional supplements.
- Table 4. Multivariable analysis with characteristics of patients significant in univariate analysis in the ONS users and high ONS users groups
Characteristics Unadjusteda Adjustedb 95% CI 95% CI Lower Upper Lower Upper OR P P OR Patient sex Male 1.0c 1.0c Female 0.7 0.023 0.6 01.0 0.993 01.0 0.7 1.4 Patient age category ≥18 to 44 years 2.9 1.9 4.5 2.5 1.5 4.3 ≥45 to 64 years 3.1 2.2 4.3 2.5 1.7 3.7 ≥65 years 1.0c <0.001 <0.001 1.0c Type of ONS d ONS type 1 1.0c 1.0c ONS type 2 0.5 <0.001 0.4 0.6 <0.001 0.6 0.4 0.8 Patient p olypharmacy No polypharmacy (<5 drugs) 1.0c 1.0c Polypharmacy (≥5 drugs) 0.7 0.5 0.9 0.8 0.6 1.2 Excessive polypharmacy (≥10) 0.6 0.010 0.5 0.9 0.550 0.8 0.5 1.3 Patient CNS drug dispensed e No CNS drug 1.0c 1.0c CNS drug (<5 drugs) 1.2 0.9 1.7 1.2 0.9 1.8 CNS polypharmacy or excessive polypharmacy (≥5 drugs) 2.5 0.002 1.5 4.3 0.029 2.4 1.3 4.4 Pati ent circulatory drug dispensed f No circulatory drug 1.0c 1.0c Circulatory drug (<5 drugs) 0.6 0.5 0.8 1.0 0.7 1.4 Circulatory polypharmacy or excessive polypharmacy (≥5 drugs) 0.5 <0.001 0.3 0.7 0.960 0.9 0.6 1.5 aBinary logistic regression carried out with each variable individually as predictor of dependent variables. bBinary logistic regression carried out with full model adjusted for all variables as predictors of dependent variables. cIndicates reference group d This variable only includes those patients who were on one ONS type, ONS type 1 includes the two most common type of ONS as per Figure 2 (high energy and very high energy standard protein sip feed with or without fibre), ONS type 2 includes the other ONS types represented in Figure 2 (high energy shots, high protein sip feed, high energy semi-solid, textured modified high energy/high protein sip feeds). eCNS drugs include drugs to treat anxiety, insomnia, psychoses, mood disorders, obsessive compulsive disorder, nausea, vomiting, vertigo, epilepsy and seizures, Parkinson's, Alzheimer's, multiple sclerosis, attention deficit hyperactivity disorder, and narcolepsy. fCirculatory medication include drugs to treat hypertension; oedema; heart failure; arrhythmias; angina; prevent myocardial infarction, stroke, and vascular events; hypercholesterolaemia; vascular diseases such as Raynaud's and pulmonary arterial hypertension; haemorrhage; anaemia and neutropenia.
CI = confidence interval. CNS = central nervous system. ONS = oral nutritional supplements. OR = odds ratio.
Supplementary Data
- BJGPO.2020.0131.pdf -
Supplementary material is not copyedited or typeset, and is published as supplied by the author(s). The author(s) retain(s) responsibility for its accuracy.
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