Portuguese Association of Enteric and Parenteral Nutrition, which meets at a congress in Porto on the 15th and 16th, warns that it is necessary to guarantee access to therapeutic care for all Portuguese people, reducing, for the sake of health, the economic impact of malnutrition in Portugal.
Annually, in Portugal, around 115 thousand patients at nutritional risk or malnourished require nutritional support using clinical nutrition. It means that two in four adults admitted to Portuguese hospitals may be at risk of malnutrition, in contrast to the European average of one in four.
This condition, whose treatment is fundamental for the patient’s recovery, mobility and autonomy, is strongly associated with increased mortality and morbidity, functional decline and prolonged hospital stays, costing the State more than 225 million euros per year.
According to Aníbal Marinho, Director of the Intensive Care Service at the Santo António Local Health Unit and president of APNEP (Portuguese Association of Enteral and Parenteral Nutrition), “we are talking about a public health problem, which affects thousands of people across the world and costs 170 billion euros annually at European level alone. Treating malnutrition is, therefore, a priority for healthcare professionals, patients and caregivers and in Portugal alone would result in a significant reduction in the burden on the NHS, with a net annual saving of over 166 million euros.”
“The reality in Portugal shows that patients who enter hospitals malnourished worsen their nutritional status and when they are discharged they need clinical nutrition in an outpatient/home context, ending up returning to hospitalization because they are unable to ensure adequate nutrition at home”, he explains. Aníbal Marinho.
Consequently, identifying and treating malnutrition early, both in the hospital and in the outpatient clinic/home, results, according to the doctor, in clinical benefits for the patient and in economic benefits for the NHS. Still, he says, it seems that “we prefer to spend and irreversibly harm the health of our patients.”
The proper implementation of nutritional screening in hospitals, provided for by Order No. 6634/2018, allows us to verify that the prevalence of malnutrition is high, higher than the European average and that it affects all regions of the country, different ethnicities and social and economic classes. “These are patients who, when discharged from hospital, leave without any support from the State to maintain clinical nutrition in the outpatient/home context. The difference here is that, regardless of economic condition, only one person will be able to access therapy if it is recommended,” he states.
It should be noted that DGS Standard 017/20230 continues to lack implementation in SNS hospitals, despite its mandatory nature. Order No. 9984/2023 also needs to be implemented, although it provides for the expansion of mandatory nutritional screening, not only in the hospital, but also for continued care.
Zero accessibility to clinical nutrition in the outpatient clinic/home “translates into high costs for the NHS, with a deterioration in the patient’s clinical condition, contrary to what happens in most European countries where 100% access is guaranteed.” For example, in Spain, clinical nutrition in outpatient/home settings has been reimbursed for more than 20 years.
“We worry about diagnosing patients and forget to check what they are eating and whether they are eating it properly. It doesn’t make sense for us to be concerned about providing cutting-edge therapies to these patients and not worry about giving them the basics: adequate nutrition”, adds the president of APNEP, who says he hopes that, with the new ULS model, screening will be implemented. nutrition and, simultaneously, the adequate training of health professionals, the proper diagnosis of malnutrition and, above all, the guarantee of equitable access for all patients to nutritional therapy.
These and other relevant issues, associated with enteral and parenteral nutrition, will be debated at the XXVI APNEP Congress, taking place between the 15th and 16th of April, at the Dr. Cupertino de Miranda Foundation, in Porto.
This event, which brings together several entities in the Health sector, intends this year to change the traditional congress organization scheme, adopting an innovative approach: “Think Outside the Box”.
The main objective is to change the current status quo in relation to the holding of major events, highlighting interactive sessions, such as the “Nutrition Quiz” between congressmen and the “Nutri Paper”, as well as the holding of small personalized sessions with 10 to 12 congressmen.
Also noteworthy are events such as the “Nutritribunal”, the “Investigation Pitch”, a debate between “Audiences and Experts” and an interactive session called “Bola Roda”. However, the commitment to an educational program remains, in a traditional format, with round tables and “Meet Expert” sessions.
