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Letter
Home parenteral nutrition during palliative care: little benefit
  1. Jane Fletcher1,
  2. Diane Woodham1,
  3. Merceline Dera1 and
  4. Sheldon C Cooper2
  1. 1 Nutrition Nurses, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
  2. 2 Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Birmingham, UK
  1. Correspondence to Jane Fletcher, Nutrition Nurses, Birmingham B15 2TH, UK; jane.fletcher{at}uhb.nhs.uk

https://doi.org/10.1136/bmjspcare-2018-001736

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    We read with interest the recent Cochrane review1 about home parenteral nutrition (HPN) in inoperable malignant bowel obstruction. They concluded it is uncertain if HPN improved length or quality of life. An evaluation of our own tertiary HPN service revealed similar outcomes in a small cohort of HPN palliative patients. Our aims were to evaluate patient selection and outcomes for palliative HPN and identify prognostic factors for future use. We retrospectively reviewed nutrition support team records from April 2015 to March 2017. Referred palliative patients identified as suitable for HPN were included. The service evaluation was registered with the Trust clinical audit department (registration number CARMS-14233) and findings were reported to the Trust strategic Nutrition and Hydration Steering Committee.

    Table 1 details key individual patient outcome data. Summarised results included four male and three female …

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    Footnotes

    • Contributors JF made substantial contributions to the article in the conception and design of the study, drafting the article and revising it critically for important intellectual content. DW and MD made substantial contributions in the conception and design of the study, acquisition and analysis of data and interpretation of data. SCC made substantial contributions in the conception and design of the study and revising the article critically for important intellectual content. All authors have approved the final version of the article to be submitted.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests JF: has participated in a BD Medical Expert Advisory Board and received an honorarium. DW: has received educational sponsorship from Calea/Fresenius-Kabi. MD: none declared. SCC: has received honoraria and participated in advisory boards for Eli Lilley, honoria from Baxter and educational sponsorship from Shire and Calea/Fresenius-Kabi

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; internally peer reviewed.