Survey on the current practice of nutritional therapy in Portugal

Background & aims: This survey aimed to provide a nationwide overview about the current practice of nutrition. Methods: Questionnaires designed by the Portuguese Association of Parenteral Enteral Nutrition were sent, with postage-paid addressee envelopes, to all hospitals and primary-care institutions. Results: Hospitals' response rate was 44/100 (44%), reaching 274/359 (60%) in primary care, P = 0.02. A Nutrition Support Team (NST) was reported in 34% hospitals, 40% of which were teaching hospitals. In 3/15 (9%) hospitals, NST nutrition prescriptions covered the whole hospital population; in 16% the NST only acted on a consultant basis; in 30% they were involved in purchasing nutrition products and in 18% the NST promoted teaching/training. Physicians alone prescribed oral, enteral and parenteral nutrition in 50%, 64% and 74% hospitals, respectively, and also monitored parenteral nutrition in 69% hospitals; monitoring oral/enteral nutrition involved dietitians in 46% and 41% hospitals, respectively; nurses were never involved in NSTs and seldom participated in nutritional management. Most primary-care institutions with hospital units (91%) provided nutrition therapy and nurses were then the most involved professionals, P = 0.001, even prescribing regimens while physicians favoured monitoring. Conclusions: Nutrition therapy is mostly unidisciplinary; the concept of a NST and its roles is wrongly perceived; education and training are eagerly awaited.