A systematic review of compliance to oral nutritional supplements
Abstract
Background & aims Oral nutritional supplements (ONS) play a key role in the management of malnutrition. This systematic review examined patients' compliance with ONS across healthcare settings and the influence of patient and ONS-related factors. Methods A systematic review identified 46 studies (n = 4328) of ONS in which data on compliance (% of prescribed quantity of ONS consumed) was available. Pooled mean %compliance was assessed overall and according to study design and healthcare setting. Inter-relationships between compliance and ONS-related and patient-related factors, and total energy intake were assessed. Results Overall mean compliance with ONS was 78% (37%-100%; 67% hospital, 81% community; overall mean ONS intake 433 kcal/d). Percentage compliance was similar in randomised (79%) and non-randomised (77%) trials, with little variation between diagnostic groups. Compliance across a heterogeneous group of unmatched studies was positively associated with higher energy-density ONS and greater ONS and total energy intakes, negatively associated with age, and unrelated to amount or duration of ONS prescription. Conclusions This systematic review suggests that compliance to ONS is good, especially with higher energy-density ONS, resulting in improvements in patients' total energy intakes that have been linked with clinical benefits. Further research is required to address the compliance and effectiveness of other common methods of oral nutritional support.
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In 46 clinical trials in mostly older participants across healthcare settings (mean age 74 years), overall compliance with ONS was 78%, better in the community (81%) than in the hospital (67%).
“In 46 clinical trials in mostly older participants across healthcare settings (mean age 74 years), overall compliance was 78%, better in the community (81%) than in the hospital (67%) (127).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [127]
There was a significant positive correlation between compliance and total energy intake, showing that ONS consumption has little effect on usual food intake.
“There was also a significant positive correlation between compliance and total energy intake (energy intake from food plus ONS energy intake), showing that ONS consumption has little effect on the usual food intake.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [127]
Compliance with ONS was higher in older than in younger patients.
“Compliance was higher in older than in younger patients.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [127]
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- Authors
- Hubbard, G. P., Elia, M., Holdoway, A., & Stratton, R. J.
- Affiliations
- Nutricia (United Kingdom) (GB)
- Southampton General Hospital (GB)
- Great Western Hospitals NHS Foundation Trust (GB)
- Corresponding author
- Hubbard, Gary P.
- Elia, Marinos
- Holdoway, Anne
- Stratton, Rebecca J.
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2012-06
- Volume
- 31
- Issue
- 3
- Pages
- 293-312
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2158574059
- Cited by
- 343
- References
- 104
- Citations by year
- 2026: 18 · 2025: 30 · 2024: 39 · 2023: 24 · 2022: 33 · 2021: 40 · 2020: 27 · 2019: 25 · 2018: 25 · 2017: 14 · 2016: 17 · 2015: 18 · 2014: 13 · 2013: 16 · 2012: 4
- FWCI
- 1.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Society for Clinical Nutrition and Metabolism
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- oral nutritional supplements, medication adherence, malnutrition, energy density, energy intake, patient factors, oral nutritional support
- MeSH terms
- Adult, Age Factors, Energy Intake, Food, Formulated, Humans, Patient Compliance, Dietary Supplements, Malnutrition
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