Abstract:

Nutrition support teams (NST) are hospital transverse nutrition care structures, recently established and developed. They include physicians, dieticians, nurses and pharmacists. In continental Europe, their prevalence is 5–10%. Nutritional assessment and care are their main actions. Education, clinical research and assessment of the practices are secondary aims of NST. NST generate benefits for patients in terms of morbidity, mortality and length of stay and consequently save money. Nutritional competence of NST members and duration of action could be predictive of good results. The pharmacist team member should contribute to the clinical assessment of food-drug interactions particularly.

Frequent challenges in clinical nutrition are cachexia and anorexia in chronic wasting diseases such as cancer or HIV. To increase the patients’ survival and outcome, the objective of interventions is to override catabolic metabolism. Nutrition support is one of the promising approaches to face wasting syndromes and malnutrition.

In this seminar, metabolic changes leading to malnutrition, medical risks, re-feeding syndrome and other life-threatening situations are discussed. Therapeutic options to improve appetite and anabolism by parenteral, enteral and tube nutrition as well as by pharmacotherapy are presented. The requested contributions of the hospital and clinical pharmacist are elucidated. 

Teaching goals:

• to explain the shift to catabolic metabolism in the most important wasting diseases
• to update delegates with the latest therapeutic approaches to face cachexia and anorexia in chronic wasting diseases
• to depict the role of hospital and clinical pharmacists in the multidisciplinary nutrition support team

Learning objectives:

After the presentation the participant should:

• recognize the emerging importance of nutritional care for chronic wasting diseases 
• be able to review his role in a multidisciplinary nutrition support team