Journal of the American Medical Directors Association
Original studyThe Effect of Megestrol Acetate on Oral Food and Fluid Intake in Nursing Home Residents: A Pilot Study
Section snippets
Subjects and Setting
Participants were recruited from a larger study designed to assess the quality of nutritional care practices. The larger study was conducted in four NHs, two of which were for-profit. The mean bed size of the four NHs was 156 (±42). Nurse-aide level staff-to-resident ratios across the four NHs, as reported by the Directors of Nursing, ranged from seven to 10 residents per nurse aide on the 7 am to 3 pm shift (eg, breakfast and lunch) and seven to 14 residents per nurse aide on the 3 pm to 11 pm
Participant Characteristics
Table 2 shows the demographic, medical, and nutritional characteristics of the 17 participants who completed the Megace trial. The participants were predominantly female (88%) and white (88%). They had mild to moderate cognitive impairment, as indicated by the prevalence of physician-recorded chart diagnoses of dementia (41%) and an average MMSE total score of 16.2 (±5.0). The prevalence of physician-recorded chart diagnoses of depression was 35%. The body mass index (BMI) of participants
Discussion
The results of this preliminary study showed that Megace did not increase the oral food and fluid intake or weight status of NH residents under usual care conditions, which consisted of inadequate feeding assistance (an average of less than 5 minutes of assistance from staff per meal). In contrast, oral intake did improve when optimal feeding assistance (an average of 30 minutes of assistance per meal) was provided to participants. Specifically, Megace given in combination with optimal feeding
Conclusion
The results of this preliminary study showed that Megace was not an effective nutritional intervention to increase the oral food intake of NH residents given inadequate feeding assistance during meals. Megace was only effective in improving oral intake when given in combination with optimal mealtime feeding assistance.
Acknowledgments
This research was supported by Bristol-Myers Squibb (Princeton, NJ), the National Institute on Aging, UCLA Claude D. Pepper Older Americans Independence Center grant (#AG 10415), and the John A. Hartford Foundation/ AFAR Medical Student Geriatric Scholars Program. The views expressed in this article are those of the authors and may not reflect those of the funding agencies.
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