ESPEN Guidelines and Initiatives for Nutritional Care Dissemination
The ESPEN guidelines provide valuable insights and recommendations for various medical conditions such as dementia, cystic fibrosis, oncology, and more. These guidelines have evolved over time, with a focus on improving dissemination strategies and involving patients in the process. Initiatives like SKOMAE aim to spread knowledge on malnutrition across Europe. The conference in Sintra, Portugal, highlighted the importance of following these guidelines and the potential impact on patient care.
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@ONCAcampaign #nutritionalcare ONCA Conference Sintra, Portugal, November 12 & 13, 2018 ESPEN Guideline ESPEN Guideline dissemination dissemination Cristina Cuerda & Stephan C. Bischoff
ESPEN Guidelines History 1st round Guidelines 2006-2009 Based on German guidelines 2nd round Guidelines 2010-2015 Dementia: Clin Nutr. 2015 Dec / Epub 2015 Sep 25 CIF: Clin Nutr. 2016 Apr / Epub 2016 Feb 8 Cystic fibrosis: Clin Nutr. 2016 May / Epub 2016 Mar 15 Oncology : Clin Nutr. 2017 Feb / Epub 2016 Aug 6 1. 2. 3. 4.
ESPEN Guidelines History 3rd round Guidelines 2015-2018 Ethics: Clin Nutr. 2016 Feb / Epub 2016 Feb 16 Terminology: Clin Nutr. 2017 Feb / Epub 2016 Sep 14 IBD: Clin Nutr. 2017 Apr / Epub 2016 Dec 31 Surgery: Clin Nutr. 2017 Jun / Epub 2017 Mar 7 Polymorbid: Clin Nutr. 2018 Feb / Epub 2017 Jul 24 Neurology: Clin. Nutr. 2018 Feb/ Epub 2017 Sep 22 Geriatrics: Epub 2018 Jun 18 Pediatrics: Epub 2018 Jun 18/27/28 ICU: Epub 2018 10. Liver: Close to publication 1. 2. 3. 4. 5. 6. 7. 8. 9.
ESPEN Guidelines 2nd + 3rd round Guidelines 2015-2018 Dementia (Volkert et al. 2015): CIF (Pironi et al 2016): Cystic fibrosis (Turck et al. 2016): Oncology (Arends et al 2016): PagesRefs Recommendations 22 61 21 38 232 623 240 475 20 112 30 43 IBD (Forbes et al. 2017): Surgery (Weiman et al. 2017): Polymorbid (Gomes et al. 2018): Neurology (Burgos et al. 2018): Geriatrics (Volkert et al. 2018): 27 28 18 43 38 326 453 104 504 361 40 37 12 88 81 Total 333 3512 463
Guidelines in the pipeline 1. HEN 2. HPN 3. Pancreas 4. Hospital food 5. Nephrology 6. Micronutrients Include 1-2 patient representatives in each guideline
Consequences Improved ESPEN guideline dissemination Shortened guideline versions Translation of short versions into national languages Guideline Apps (english and national languages) Lay guidelines for patients Agreement on this at the last Council Meeting in Nice, Jan 2018
UEG Activity Grants (spring 18) Support of Standards & Guidelines initiatives Dissemination of existing clinical practice guidelines and standards Title of the ESPEN initiative: Spreading knowledge on malnutrition across Europe (SKOMAE) Oct 2018 Oct 2020
Participants 1/2 Lead UEG Member Society: ESPEN The European Society of Clinical Nutrition and Metabolism Scientific coordinator: Stephan C. Bischoff, University of Hohenheim, Stuttgart 4 UEG National Member Society from a country with a low HDI: CROATIA Hrvatsko gastroenterolo ko dru tvo MACEDONIA Macedonian Society of Gastroenterohepatology MONTENEGRO Gastroenterohepatology Association of Montenegro SERBIA Association of Serbian Gastroenterologists (ASG) 3 UEG National Member Society from a country with a high HDI: AUSTRIA sterreichische Gesellschaft fu r Gastroenterologie und Hepatologie BELGIUM (SRBGE) Soci t Royale Belge de Gastro-Ent rologie GERMANY Deutsche Gesellschaft fu r Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS)
Participants 2/2 10 Others (European Parenteral/Enteral Nutrition PEN ) societies: AUSTRIA Arbeitsgemeinschaft Klinische Ern hrung (AKE) BELGIUM Soci t Belge de Nutrition Clinique (SBNC) CROATIA Croatian Society of Clinical Nutrition (CSCN) FRANCE SFNEP the French Speaking Society for Clinical Nutrition and Metabolism* GERMANY Deutsche Gesellschaft fu r Ern hrungsmedizin (DGEM) GREECE Hellenic Society for Clinical Nutrition and Metabolism ITALY Italian PEN Society (SINPE) MACEDONIA Macedonian Society for Parenteral and Enteral Nutrition SPAIN Sociedad Espa ola de Nutrici n Cl nica y Metablismo (SENPE)
1. Shortage of guidelines Recommendations and grading cannot be changed! Only commentary can be shortened Grading-relevant references cannot be removed Only supplementary references can be omitted Will be done by the guideline office and proofread by the guideline officer and the guideline group leader
2. Translation into national languages (national GL) Based on shortened versions authorisized by the GL office Selected recommendations can be marked or removed if contradictionary to local rules Recommendations relevant for the local situation can be added if they cover additional aspects and are not contradictory to existing recommendations Added recommendations have to be marked as such National guidelines can be published in National Journals, if original authors are included & ESPEN is indicated adequately Done by national representative(s) nominated by the national PEN/Gastro society (supported by ESPEN with 1000 each ?????)
3. Patient guidelines based on ESPEN guidelines Start with the IBD and the CIF guideline Cooperation with ECCO (European Crohn's & Ulcerative Colitis Organization) and EFCCA (European Federation of Crohn's & Ulcerative Colitis Associations, an umbrella organisation representing 34 national patient associations) Looking for other appropriate patient organisations Start with English versions Translation into national languages possible (if interest by national PEN societies) Done by ESPEN in collaboration with Patient representatives (Cees Smith and others) and Patient organizations (EFCCA and others)
ESPEN guideline Apps DGEM In cooperation with DGIM DGVS DGAV
Dissemination strategy Short versions Patients versions Translation Apps versions
Selection of ESPEN guidelines Terminology (Cederholm et al) IBD (Forbes/Bischoff et al) Surgery (Weimann et al) CIF (Pironi et al) Cancer (Arends et al) Neurology (Burgos et al) Geriatrics (Volkert et al.) ICU (Singer et al.) Liver (Plauth et al.) 10. Home EN (Bischoff et al.) Consensus Conference 2 Sep 18, 11. Home PN (Pironi et al.) Consensus Conference Apr 19 12. Pancreas (Arvanitaki et al.) Consensus Conference Apr 19 IV/2018 IV/2018 I/2019 I/2019 II/2019 1. 2. 3. 4. 5. 6. 7. 8. 9.
Invitation Tue, 4th Sep., 10:30-12:00, Rm. N103-104: New ESPEN guidelines 29th April 2019, Frankfurt Airport: Consensus Conference HPN & Pancreas Information: guidelines-office@espen.org
