La realidad de la nutrición parenteral domiciliaria en España

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Abstract

Es importante conocer la magnitud y características de de la Nutrición Parenteral Domiciliaria NPD en España fundamentalmente para facilitar que la toma de decisiones tanto clínicas como de gestión se realicen basadas en el conocimiento. Objetivo: conocer el alcance y las características de la NPD en España durante el año 2008. Material y métodos: Estudio Descriptivo Transversal en los 713 hospitales Españoles incluidos en el listado del Ministerio de Sanidad, Política Social e Igualdad que cumplieron los criterios de inclusión. durante el año 2008. Se contactó con los Servicios de Farmacia Hospitalaria mediante encuesta telefónica. Resultados: De los 713 hospitales incluidos, 62 (8,70%) llevaron a cabo NPD, tratando a 228 pacientes, de los que 201(88,16%) fueron adultos. La prevalencia en España de NPD fue de 4,91/10(6) habitantes durante el año 2008, siendo en adultos de 5,06 /10(6) habitantes y en niños 4,01/10(6) habitantes. La Comunidad Autónoma de Madrid fue la de mayor prevalencia 11,53/10(6) habitantes. El seguimiento lo realizaron las Unidades de Nutrición en 26 de los hospitales. Conclusiones: Con este trabajo se establece una base para futuros análisis e investigaciones sobre la situación de la NPD así como puede ser un referente para diferentes registros.

Translated abstract

It is important to be acquainted with the magnitude and characteristics of Parental Home Nutrition NPD in Spain to fundamentally provide decision making in clinics as well as the steps to be taken based on knowledge. Aim: To be aware of the perception and characteristics of the NPD in Spain throughout the year 2008. Material and methods: Description Time Research made in the 713 Spanish hospitals including those listed in the Health, Social, Social Political and Equanimity Ministry, which fulfilled the criterion inclusion during 2008. The Hospital Pharmacy Services were contacted through telephone survey. Results: From the 713 hospital included, 62 (8,70%) carried out NPD, treating 228 patients, of which 201 (88,16%) were adults. The prevalence in Spain was of 4,91/10(6) inhabitants during 2008, being in adults 5,06/10(6) inhabitants and in children 4,01/10(6) inhabitants. The Autonomous Community of Madrid reached the highest prevalence 11,53/10(6) inhabitants. The Nutritional Units carried out the following up in 26 of the hospitals. Conclusions: With this work, a base for the future analysis and investigation about the situation of the NPD is established. It can also be a reference for different data bases.

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Most cited references 45

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Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States.

M Ament, M Shike, Daryl Howard … (1995)

Home nutrition support, especially when delivered parenterally, is very costly. The aim of this study is to examine current usage of home parenteral and enteral nutrition (HPEN) in the United States and the quality of therapy outcome. Medicare HPEN use from 1989 to 1992 was analyzed to assess use, growth, and costs. National Registry information collected on 9288 patients treated with HPEN from 1985 to 1992 was used to assess disease distribution and therapy outcome. In the United States, there were approximately 40,000 parenteral and 152,000 enteral home patients in 1992. The usage of HPEN doubled between 1989 and 1992, and a large proportion was in patients with short survival. The prevalence of HPEN in the United States was 4-10 times higher than in other Western countries. Outcome data showed both therapies were relatively safe. The primary disease strongly influenced survival and rehabilitation, and age, per se, was not a reason to deny HPEN. Predicted quality survival at home for several months, rather than a specific diagnosis, seems to be the soundest justification for HPEN. Its role in terminal conditions and patients without primary gastrointestinal diseases needs further evaluations.

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Survey on legislation and funding of home artificial nutrition in different European countries.

António Moreno, M Staun, F. Bozzetti … (2001)

Home Artificial Nutrition (HAN) has been an expanding area over the last 30 years. HAN programs have been often developed prior to the regulation by the National Health Systems (NHS) leading to different policies within European countries. The aim of this study was to compare legislation regarding HAN in Europe. The Group elaborated two structured questionnaires (one for Home Enteral Nutrition--HEN--and one for Home Parenteral Nutrition--HPN) which were presented to all the members of the HAN-Working group and to the 21 ESPEN Council members. Twelve questionnaires were returned, covering for more than 375 million inhabitants. HEN: regulated in seven countries, Italy and France being the first to implement reimbursement policy in 1988. Except in France, Croatia and the Czech Rep almost any physician can prescribe HEN. NHS totally or partially fund HEN, although in Austria and Israel expenses are paid for the patients. Provision of enteral diets and equipment varies widely within countries. As in HPN, most of the countries have written guidelines for health care workers and for patients. HPN: legislated in six countries, Denmark being the first in 1975. HPN programs are restricted to a few hospitals and patients are followed by Nutrition Support Teams (NST). The budget for HPN is 100% supported by NHS. Hospital pharmacy, private pharmacists and Home Care companies are involved in a different degree in providing and distributing solutions and disposables. HPN regulation preceded HEN regulation by 10-20 years. Due to this longer experience and high level of care, HPN patients are usually followed by NST. Despite different policies, funding is relatively uniform, NHS supporting most of the expenses for HAN. ESPEN could play a key role developing common standards for HAN all over Europe. Copyright 2001 Harcourt Publishers Ltd.

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Nutrición parenteral domiciliaria (NPD): registro NADYA. Año 2000

M. Planas, M Castellá, M. León … (2003)

Objetivo: Análisis descriptivo y valoración de los datos registrados por el Grupo de Trabajo NADYA-SENPE de pacientes que han recibido nutrición parenteral domiciliaria (NPD) en nuestro país durante el año 2000. Material y métodos: Se han recopilado datos (epidemiológicos, diagnóstico, vía de acceso, complicaciones, reingresos hospitalarios, duración del tratamiento y evolución) a partir de un cuestionario previamente diseñado para ello. Los datos obtenidos del cuestionario se introdujeron en una base de datos para la ulterior gestión de los mismos. Resultados: Los datos correspondían a 67 pacientes (edad media de 5 ± 4 años para pacientes < 14 años y 48 ± 15 años para ≥ 14 años) controlados por 14 centros hospitalarios. Las patologías que con más frecuencia han comportado este tratamiento fueron: isquemia mesentérica (28,4%), seguida de enfermedad neoplásica (16,4%), enteritis rádica (13,4%), alteraciones de la motilidad (7,5%) y enfermedad de Crohn (2,9%), entre otras. Se observó un predominio de los catéteres tunelizados (77,6%) sobre los implantados (20,9%), y de la administración cíclica (nocturna) de la nutrición parenteral (NP) (91,0%). Las farmacias hospitalarias suministraron las fórmulas de NPD con más frecuencia que el Nutriservice (71,5% frente a 19,4%). La duración media del tratamiento fue de 7,48 ± 4,39 meses. Se presentaron 0,32 complicaciones/100 días de NPD relacionadas con el tratamiento nutritivo con predominio de las infecciosas (0,12 sepsis por catéter/100 d de NPD), seguidas de las metabólicas (0,06/100 d de NPD), y de las mecánicas (0,03/100 d de NPD) e hidroelectrolíticas (0,03/100 días de NPD). Estas complicaciones comportaron 0,3 hospitalizaciones/ 100 días de NPD. Al finalizar el año, seguían en activo 61,2% de los pacientes; 37,3% habían abandonado el tratamiento (exitus 40%, nutrición oral 48% y nutrición enteral 4%), y 1,5% pacientes habían dejado de ser controlados por el equipo inicialmente responsable. Conclusiones: Podemos concluir que existe un incremento del registro de la NPD en nuestro país (1997: 0,7 pacientes/10(6) habitantes, 2000: 1,9 pacientes/10(6) habitantes), que hay un predominio de patología vascular y que la incidencia de complicaciones, retirada del tratamiento e ingresos hospitalarios son semejantes a otras series lo que avala la calidad del tratamiento.

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Author and article information

Contributors

J. Juana-Roa: Role: ND

C. Wanden-Berghe: Role: ND

J. Sanz-Valero: Role: ND

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Journal ID (publisher): nh

Title: Nutrición Hospitalaria

Abbreviated Title: Nutr. Hosp.

Publisher: Sociedad Española de Nutrición Parenteral y Enteral (Madrid )

ISSN: 0212-1611

Publication date (Print): April 2011

Volume: 26

Issue: 2

Pages: 364-368

Affiliations

[1 ] Universidad de Alicante Spain

[2 ] Universidad CEU Cardenal Herrera Spain

[3 ] Hospital General Universitario de Alicante Spain

[4 ] Universidad Miguel Hernández Spain

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Publisher ID: S0212-16112011000200018

SO-VID: b29d9371-b4bf-472f-bcd4-df0f76820ef9

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http://creativecommons.org/licenses/by/4.0/

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SciELO Spain

Self URI (journal page): http://scielo.isciii.es/scielo.php?script=sci_serial&pid=0212-1611&lng=en

La realidad de la nutrición parenteral domiciliaria en España Translated title: The reality of home-based parenteral nutrition in Spain

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Most cited references 45

Current use and clinical outcome of home parenteral and enteral nutrition therapies in the United States.

Survey on legislation and funding of home artificial nutrition in different European countries.

Nutrición parenteral domiciliaria (NPD): registro NADYA. Año 2000

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