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What Advanced Practice Roles Are Dietitians Undertaking? A Mixed Methods Systematic Review
Kim Lunardi1,2, Adam D Walsh2, Adrienne K Forsyth2
1St Vincent's Hospital Melbourne, Fitzroy, Australia.
Summary
Advanced practice (AP) roles for dietitians are expanding globally. This review found few dietetic roles fully met the British Dietetic Association (BDA) AP pillars, indicating a need for more research.
Area of Science:
- Health Services Research
- Allied Health Professions
- Dietetics
Background:
- Global health systems face increasing demands, with allied health professionals in advanced practice (AP) roles supporting medical teams and enhancing efficiency.
- Dietitians undertaking AP roles are crucial in optimizing health system performance and patient outcomes.
- The British Dietetic Association (BDA) provides a definition and capabilities framework for AP in dietetics.
Purpose of the Study:
- To identify the advanced practice (AP) roles currently undertaken by dietitians.
- To evaluate how these identified dietitian AP roles align with the British Dietetic Association (BDA) definition of AP.
- To synthesize findings from a mixed-methods systematic review on dietetic advanced practice.
Main Methods:
- A systematic literature review was conducted using MEDLINE, CINAHL, and Web of Science.
- Inclusion criteria focused on peer-reviewed English-language articles describing dietitian AP roles, assessed against BDA AP capabilities.
- Joanna Briggs Institute (JBI) critical appraisal tools and PRISMA 2020 guidelines were utilized for quality assessment and reporting.
Main Results:
- Six studies published between 1993 and 2014 were included, primarily from the USA (5) and UK (1).
- Five specialist AP roles were identified: inherited metabolic diseases (IMD) dietitian, advanced specialist practitioners in paediatric, metabolic, and renal fields, advanced practitioners in diabetes, and two generalist roles.
- Key themes related to the BDA AP pillars were synthesized from the included studies.
Conclusions:
- A limited number of dietetic advanced practice (AP) roles fully aligned with all British Dietetic Association (BDA) AP pillars were identified.
- Discrepancies in AP definitions across geographical regions and professional bodies, coupled with potential underreporting, suggest the review may underestimate the scope of current dietetic AP.
- High-quality research clearly aligning dietitians' advanced practice with established AP frameworks is essential to demonstrate the value of dietetic AP in global healthcare.
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