On 2015 Dec 09, Cicely Saunders Institute Journal Club commented:

The Cicely Saunders Institute journal club reviewed this paper on Wednesday 4th November 2015. We enjoyed discussing this paper and appreciated that the authors had tackled an important question about the efficacy of nutritional interventions, which are widely used in the NHS and associated with substantial costs, but with little evidence for improving function in this population. The paper reports an interesting example of a feasibility trial. We agreed with the authors that the participating care homes are unlikely to be representative due to their prior involvement in a dietetic intervention, which limits the conclusion regarding the feasibility of a future trial beyond these care homes. The authors recognised that using weight and BMI as outcomes is problematic; despite being widely used clinical markers they are not directly measuring or necessarily indicative of function. Therefore, we wondered if this feasibility trial might have included alternative outcomes more aligned with the aim of the study. One suggestion is to look at incidence of pressure ulcers or infections which would be available in routinely recorded clinical notes. In addition, we were interested that consent was not sought from most participants and felt this warranted further attention and justification – consenting adults who lack capacity presents challenges but is not impossible. However, we were pleased to see this study contributing to the growing body of work in the care home population.

Commentary by Joanna Davies (@JoannaDavies58), Research Assistant at the Cicely Saunders Institute, KCL.

On 2015 Dec 09, Cicely Saunders Institute Journal Club commented:

The Cicely Saunders Institute journal club reviewed this paper on Wednesday 4th November 2015. We enjoyed discussing this paper and appreciated that the authors had tackled an important question about the efficacy of nutritional interventions, which are widely used in the NHS and associated with substantial costs, but with little evidence for improving function in this population. The paper reports an interesting example of a feasibility trial. We agreed with the authors that the participating care homes are unlikely to be representative due to their prior involvement in a dietetic intervention, which limits the conclusion regarding the feasibility of a future trial beyond these care homes. The authors recognised that using weight and BMI as outcomes is problematic; despite being widely used clinical markers they are not directly measuring or necessarily indicative of function. Therefore, we wondered if this feasibility trial might have included alternative outcomes more aligned with the aim of the study. One suggestion is to look at incidence of pressure ulcers or infections which would be available in routinely recorded clinical notes. In addition, we were interested that consent was not sought from most participants and felt this warranted further attention and justification – consenting adults who lack capacity presents challenges but is not impossible. However, we were pleased to see this study contributing to the growing body of work in the care home population.

Commentary by Joanna Davies (@JoannaDavies58), Research Assistant at the Cicely Saunders Institute, KCL.