An evaluation of the feasibility and validity of a patient-administered malnutrition universal screening tool ("MUST') compared to healthcare professional screening in an inflammatory bowel disease (IBD) outpatient clinic

BackgroundMalnutrition is common in inflammatory bowel disease (IBD) and is associated with poor health outcomes. Despite this, screening for malnutrition in the outpatient-setting is not routine and research in the area is limited. The present study aimed to evaluate whether agreement between malnutrition screening completed by patients and healthcare professionals (HCPs) could be achieved by comparing patient self-administered MUST' (MUST'-P) with HCP administered MUST' (MUST'-HCP) in a single tertiary IBD outpatient clinic. MethodsWe conducted a feasibility and validity study on adult outpatients with IBD. We collected anthropometric, nutritional and clinical data from patients. All patients completed MUST'-P using a self-administered questionnaire, followed by MUST'-HCP. MUST'-P was timed and feedback on ease-of-use was obtained. The risk of malnutrition was classified as low (score=0), medium (score=1) and high (score2) and agreement was tested using kappa statistics (). ResultsEighty patients were recruited (Crohn's disease: n=49, ulcerative colitis: n=29, unclassified: n=2), with a mean (SD) age of 39.9(15.1)years (51.2% were males). Seventy-one (92%) of patients found MUST'-P either easy or very easy. The mean (SD) time to complete MUST'-P was 3.1 (1.8)min (range 1-10min). Sixty-eight (85%) of patients were at low risk of malnutrition when screened by the HCP. There was moderate agreement (=0.486, P<0.001) between MUST'-P and MUST'-HCP, with 100% agreement in scoring for medium- and high-risk categories. ConclusionsThe results of the present study suggests that self-screening using MUST' could be effectively used in an IBD outpatient clinic to identify those at medium and high risk of malnutrition. The patient friendly version of MUST' (MUST'-P) was considered quick and easy to use by patients. Implementation of self-screening with MUST' could improve the nutritional management of IBD patients.