Sip feed prescribing in primary care: an audit of current practice in Greater Glasgow Health Board, Glasgow, UK

Background and aims: Prior to September 1995, prescribing of sip feeds had been increasing at a higher rate than any other part of the drugs bill. An increase in requests far information on the use of these products led the Prescribing Advisers Department to seek funding for a 1-year project to document current practice in this area and produce guidelines for GPs, their practice nurses and district nurses. Methods: Questionnaires were completed by GPs (n = 52), district nurses (n = 94) and dietetic departments (n = 8) concerning current practice. In addition, 90 patients were interviwed and in all but one instance case notes were also consulted. Results: The most significant findings were that Primary Care staff see palliative care as one of the main areas of usage of these products and that 40% of patients were found to have some degree of undernutrition. The majority of patients interviewed were elderly and 10% of patients interviewed were in nursing homes. A significant proportion of patients interviewed had commenced sip feeds whilst in hospital. The majority of patients reported receiving no advice on diet with only one GP making written dietary advice available to patients. Finally, district nurses view company representatives as the most useful source,of information on these products. Conclusions: In response to these findings, the project included the development of a standard communication form from secondary to primary care, dietary information resource development, development of guidelines on oral nutrition support in Primary Care and GP and district nurse training.