Implementation of Enteral and Parenteral Nutrition for Adult Outpatient

The National Clinical Standard “Implementation of Enteral and Parenteral Nutrition for Adult Outpatient” from Directorate-General of Health was published on 25/09/2020. Dr. Aníbal Marinho of APNEP is part of the panel of experts that developed this standard.

The document is a practical guideline for mandatory implementation of the clinical standards so it doesn’t define the reimbursement model but it’s a huge step in the right direction – the legal framework definition for access to Enteral and Parenteral Nutrition in the community.

In summary, the document includes:

• Definition of “Enteral & Parenteral Nutrition Groups” within public hospitals;
• Scope of these groups: ensure that standards are implemented/monitored/checked & that each outpatient in need for medical nutrition has fair access to enteral (ONS & TF) and parenteral nutrition
• Definition of the “Individual Nutritional Care Plan for Enteral & Parenteral Nutrition”
• Discharge algorithms for Enteral & Parenteral Nutrition
• Diseases eligible for Enteral and Parenteral Nutrition in the community

 

Strategy

First of all, the guideline defines how Home Enteral and Parenteral nutrition is going to be implemented after hospital discharge – opening the door to the access to medical nutrition in the community to become a reality in Portugal.

Secondly, it reinforces the MoH commitment and alignment on the objective: ensuring the access to enteral and parenteral nutrition for malnourished outpatients.

Next steps

Next step is the publication of a legislative framework for access/reimbursement to Enteral and Parenteral Nutrition in the community.