P392 Comparing the accuracy and ease of use of self-administered ‘Malnutrition Universal Screening Tool’ (MUST) to screening by a health care professional using MUST to explore malnutrition rates in an outpatient inflammatory bowel disease
S. Zacharopoulou-Otapasidou*1, K. Keetarut1, S. Bloom2, S. McCartney2
1University College London Hospital, Nutrition and Dietetics Department, London, United Kingdom, 2University College London Hospital, Department of Gastroenterology, London, United Kingdom
Malnutrition is common in inflammatory bowel disease (IBD) patients. However, in the outpatient setting, patients are not routinely screened for malnutrition, and there is limited research in the area. The aim of this research was to identify malnutrition rates in the outpatient setting of University College London Hospitals (UCLH), as well as whether self-administered MUST (Self-MUST) can be accurately implemented in the IBD outpatient setting to identify malnutrition.
This study is a quantitative research survey design, including 80 participants with IBD (Crohn’s disease: 43, ulcerative colitis: 29, Crohn’s colitis: 6, IBD Unclassified: 2), mean age 39.9 ± 15.1 years (range 19–84), and 51.3% were females. The chance-correlated agreement (kappa-κ) coefficient (using grading system of Landis and Koch) was used to compare the Self-MUST score to the MUST score calculated by the dietitian (low score = 0, medium score = 1, and high score = ≥ 2).
In total, 68 (85%) of the participants, were at low risk of malnutrition when screened by the researcher. Further, 40 (50%) participants found completion of the Self-MUST easy; 31 (38.8%) participants found it very easy; and only 3 patients refused to complete the Self-MUST.
The estimated time needed to complete the Self-MUST ranged from <1 minute (minimum) to 10 minutes (maximum). The most common times to complete the Self-MUST were 3 minutes and 2 minutes by 21 (26.3%) participants and 19 (23.8%), respectively.
The κ coefficient was 0.486 (p < 0.001) showing a moderate agreement between the scoring of MUST by participant and researcher. There was 100% agreement in MUST scoring for participants and researcher for medium and high malnutrition risk categories.
Our study suggests that the prevalence of malnutrition in the IBD outpatient setting at UCLH is low: the majority of the patients had a MUST score of 0 indicating low malnutrition risk. Close monitoring by a multidisciplinary team might enhance the low levels of malnutrition in the outpatient setting. This study identified that a self-administered MUST could be implemented in an outpatient IBD clinic to ensure effective nutritional screening as there is a satisfactory agreement with the health care professional’s nutritional screening result using MUST. Additionally, using computers for calculations could improve accuracy and make nutritional screening much easier.
Further research is currently underway, exploring clinicians’ and patients’ perceptions on the implementation of a self-administered nutritional screening tool in an outpatient IBD setting. Exploring barriers and facilitators could help to develop the self-administered MUST further and improve accuracy.