A British Journal of Nutrition (BJN) article on BAPEN’s ‘Malnutrition Universal Screening Tool’ (‘MUST’) has been recognised as ‘seminal’ in a recent review, being one of the most highly cited papers from this journal over the years.

The early paper, published in 2004, addressed aspects of malnutrition in inpatients and outpatients at Southampton General Hospital and the introduction of ‘MUST’ which had been launched by BAPEN’s Malnutrition Advisory Group (MAG) the previous year. The review contextualises the BJN article by providing an overview of the work of BAPEN at its establishment in 1992, signposting the importance of a widely accepted definition of malnutrition and the need for a universal screening tool.

In the review, the now highly cited article is credited for increased awareness and interest in the burden of malnutrition and its management, and while ‘MUST’ was already endorsed by multiple organisations, the paper engendered support from Royal Colleges and other governmental and non-governmental organisations.

The 2004 paper was one of the first articles to illustrate that malnutrition could be detected and managed using the ‘MUST’ framework in both hospitalised patients and free-living community patients attending outpatient clinics. Apart from highlighting the issues associated with the management of malnutrition in hospital and emphasising the common clinical problem, it offered a management plan following the ‘MUST’ guidance notes.

Within a few years, ‘MUST’ became the most commonly used screening tool in hospital, community and care home settings, eclipsing all previous screening tools in the UK.

Many national policies, economic reports, and reports on malnutrition, based on the ‘MUST’ framework, were launched, some in the House of Commons with ministerial support. On top of this, NICE produced guidelines on nutritional support in adults and a quality standard, citing the BJN article and using the ‘MUST’ framework.

The review concludes that the 2004 paper both contributed and resulted from systematic efforts to improve detection and treatment of malnutrition in the UK.

The full review is available to read here.

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