ADHERENCE HEGITO 7 STUDY
Description
Adherence is one of the priorities of WHO to optimalize the medical care. Data on adherence to oral nutritional supplements (ONS), particularly in patients with advanced chronic liver disease, is scarce. This is the supplementary material of baseline and follow-up characteristics of patients admitted with liver cirrhosis to tertiary liver unit who consented to be enrolled in study analysing post-discharge adherence to ONS. All these patients received standard of care for cirrhosis and its specific complications (including waitlisting for liver transplant, TIPS, et.) and nutritional counselling. Nutritional counselling was focused on: 1)explaining the frequency of malnutrition and sarcopenia in cirrhosis; 2)their prognostic impact; 3)the importance of provision of enough calories and proteins (with calculations [>= 35 kcal/kg/day, and >1,5 g/kg/d, respectively); 4)importance of the frequency of meals + night-time snack; 5)that we would like to know how much of these calculated doses are consumed in real-life and the importance of these data; 6)that ONS serve as the easy, balanced and sofisticated way to convey both calories and proteins to even demand; 7)how important is exercise; 8)patients were provided printed materials (e.g. figures how to exercise); patients were provided graphic easy to understand record of ONS use; 9)they were explained that we will extract data on the use of ONS from the surrogates and from pharmacy refills. After discharge, they were recommended to attend to a regular follow-up visits at months 1, 3, 6, and 12, and whenever clinically indicated. In parallel, we recorded mortality via the state agency. They were advised to bring the records. Polymeric, and oligopeptide ONS formulas were chosen on the basis of then availability (insurance covered) basis. Besides the triple ONS-adherence record, they were examined by regular plus anthropometric investigations, as well as the Liver frailty index. Our hypotheses: 1)we do not know how many patients adhere to ONS after discharge - no pre-formulated hypothesis on the primary endpoint (our speculation was that adherence was suboptimal) 2)good adherence leads to a better survival 3)good adherence is reflected by anthropometric and laboratory indicators of malnutrition, as well as by LFI 4)we will be able to start deciphering barriers to adherence and conceive barriers-specific interventions