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Published on: September 20, 2019
Comparing two durations of medically tailored meals posthospitalization: A randomized clinical trial
Rebecca Boxer1, Melanie L Drace2, Cheryl Kelly3
1Department of Medicine, Division of Geriatrics, Hospice and Palliative Care, University of California, Davis, California, USA.
Background:
Medically tailored meals (MTM) may be beneficial to patients after hospital discharge.
Objective:
To determine if 2 versus 4 weeks of MTM posthospitalization will improve patient outcomes.
Design:
Randomized unblinded trial.
Settings And Participants:
Six hundred and fifty patients pending hospital discharge with at least one chronic condition.
Intervention:
One MTM a day for 2 versus 4 weeks.
Main Outcome And Measures:
The primary outcome was a change from baseline to 60 days in the Hospital Anxiety Depression Scale (HADS). Secondary outcomes measured change in the Katz activities of daily living (ADLs), DETERMINE nutritional risk, and all-cause emergency department (ED) visits and rehospitalizations.
Results:
From baseline to 60 days the HADS anxiety subscale changed 5.4-4.9 in the 2-week group (p = .03) and 5.4-5.3 in the 4-week group (p = .49); the difference in change between groups 0.4 (p = .25). HADS changed 5.4-4.8 in the 2-week group (p = .005) and 5.3-5.1 in the 4-week group (p = .34); the difference in change between groups 0.4 (p = .18). ADL score changed from 5.3 to 5.6 in the 2-week group (p ≤ .0001) and 5.2-5.5 in the 4-week group (p ≤ .0001); the difference in change between groups -0.01 (p = .90). The DETERMINE changed in the 2-week group from 7.2 to 6.4 (p = .0006) and from 7 to 6.7 in the 4-week group (p = .19); the difference in change between groups 0.5 (p = .13). There was no difference in ED visits and rehospitalizations between groups or time to rehospitalization.
Conclusions:
Different durations of short-term MTM did not affect patient-centered or utilization outcomes.
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