An analysis on selected topics was undertaken using information gathered from the British Artificial Nutrition Survey between 1996 and 2002.
Trends in Home Enteral Tube Feeding
- The numbers of patients on HETF has continued to grow between 1996 and 2002, although the growth has slowed in the last 12 months. The total number of adults and children receiving HETF in the UK at the end of 2002 was estimated to be in the region of 22,000-27,000.
- The number of new patient registrations over the age of 60 years is increasing. 78% of those over 60 years require some or total help. This older and more dependent adult population has implications for healthcare resources.
- Data from the annual BANS survey in 2002 demonstrates that arrangements for follow-up and monitoring of patients receiving HETF are made prior to discharge by 84% of centres.
- There has been a steady rise in the use of commercial home delivery companies for both adults and children, with approximately 82% of new HETF patients using this type of service in 2002.
- Under-reporting remains an area of concern to the BANS Committee. Given that the majority of HETF patients are registered on commercial systems, a working partnership with such systems should be explored to facilitate more accurate and complete data collection.
Trends in Home Parenteral Nutrition
- The number of patients on HPN continues to show some growth and it is estimated that the number of adults and children on HPN at the end of 2002 in the UK was at least 600.
- Point prevalence increased from 490 to 533 between 2001and 2002 (approximately 9%).
- It appears that there is large regional variation in the UK in the provision of HPN to both adults and children. It is of concern that the equity of access to present services is variable and that standards of care differ according to geographical location, workload and experience.
In-patient Parenteral Nutrition
- In 2001, BANS noted that only 34% of registering centres responding to the annual survey audited infection (catheter-related sepsis). The situation has not improved in 2002 with catheter sepsis rates being audited in only 32% of responding centres.
- The incidence of catheter-related infection tended to be higher where there was no NST (13.5% versus 7.7%), but this figure was not statistically significant.
Patients with Cerebral Palsy and Cystic Fibrosis receiving HETF
- The number of children with cerebral palsy registered on BANS has increased from 348 in 1996 to 783 in 2002 (point prevalence). In contrast, the number of children registered on BANS with cystic fibrosis has changed very little and remains around 180 (point prevalence), while the number of registered adults with cystic fibrosis has almost doubled.
- The proportion of children with cerebral palsy receiving nasogastric feeding at home has increased steadily, while gastrostomy feeding has declined, the trend also being observed in all children receiving HETF. Prolonged survival in children with cerebral palsy means there is an increasing demand on healthcare resources and survival to adulthood means that transfer of care to adult services must be addressed. In 2002, 783 children and 551 adults with cerebral palsy were registered on BANS (point prevalence).