Monitorin patients on home parenteral nutrition

Monitoring of patients on home parenteral nutrition (HPN) is essential for evaluation of treatment effect and management of the complications associated with this treatment. Monitoring is most often carried out at the discharging hospital with access to the specialised nutrition team. Monitoring can also be performed by a home care agency involving the hospital or the general practitioner. Intervals between visits vary, being on average 3 months. The unstable patient may need more attention. Assignment of responsibility for monitoring is probably very important for the quality of the process. A previous questionnaire-based study indicated that in general responsibility is assigned to a specific person most often associated with the specialised team in hospital. Biochemistry, anthropometry should be measured at all visits, trace elements, vitamins and bone mineral density only occasionally, yearly intervals are recommended. Official guidelines for monitoring are not available and prospective studies on the impact of different monitoring regimens on outcome including the quality of life of HPN patients are warranted.