{"id":2766,"date":"2022-02-11T11:52:10","date_gmt":"2022-02-11T11:52:10","guid":{"rendered":"https:\/\/thepafp.org\/journal\/?page_id=2766"},"modified":"2024-01-09T06:33:37","modified_gmt":"2024-01-09T06:33:37","slug":"clinical-practice","status":"publish","type":"page","link":"https:\/\/thepafp.org\/journal\/clinical-practice\/","title":{"rendered":"Clinical Practice"},"content":{"rendered":"

Sponsored Article<\/p>\n<\/div><\/div><\/div><\/div>

Position Statements on Oral Micronutrient Supplementation in Nutrition and Appetite Support Across the Continuum of Care<\/h1><\/div>

Karin Estepa-Garcia, MD; Joy Arabelle Fontanilla, MD; Maria Antonia Ocampo-Yamamoto, MD; Pia Angela Receno, MD; Joel Marquez Santiaguel, MD and Marianna Ramona Sy-Quia-Sioson, MD<\/p>\n<\/div><\/div><\/div>

Introduction<\/strong><\/p>\n

A Technical Working Group composed of health professionals and multispecialty healthcare experts, have come together to emphasize the crucial role of nutrition in promoting overall health and well-being. Nutrition serves as the cornerstone of optimal physical and mental functioning, and they firmly believe that a well-balanced diet should be the primary source of essential nutrients for individuals of all ages. However, they acknowledge the existence of prevalent gaps in nutrition and the potential benefits of oral micronutrient supplementation particularly those that contain iron and appetite stimulants in addressing these gaps across the entire disease spectrum.<\/p>\n

Despite the importance of nutrition, various factors like appetite loss due to medications and illnesses contribute to gaps in dietary intake. Modern dietary patterns, often characterized by highly processed foods, excessive added sugars, unhealthy fats, and insufficient intake of fruits, vegetables, whole grains, and lean proteins, can result in nutrient deficiencies. Additionally, socio-economic factors, cultural practices, limited access to nutritious food options, and individual dietary restrictions may further contribute to these gaps. Moreover, individuals who have poor appetite and nutrient intakes with certain conditions, or those who avoid certain foods (such as strict vegetarians and vegans) might benefit from taking supplementation.<\/p>\n

Multivitamin supplementation can play a supportive role in addressing nutritional gaps. These supplements, when used appropriately and as part of a balanced diet, can provide a convenient and reliable source of essential vitamins and minerals. Multivitamins are particularly useful in situations where dietary intake alone may not meet individual nutrient requirements due to limitations or specific health conditions. They offer an accessible option to help bridge the nutritional gaps and ensure adequate nutrient intake.<\/p>\n<\/div>

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Â鶹ֱ²¥ Clinical Pathways and Guideline Development Method<\/h1><\/div>

Research Committee, Â鶹ֱ²¥.<\/p>\n<\/div><\/div><\/div>

\"\"Clinical Pathways, Guidelines and Consensus Statements<\/strong><\/p>\n

Clinical pathways, guidelines and consensus statements are essential tools to ensure quality health care. Clinical Pathways, guidelines and consensus statements are guidance statements develop to provide information to health care providers on the best care for a patient. All statements are systematically developed. Clinical practice guidelines statements are based on relevant and quality scientific literature that includes an assessment of the likely benefits and harms of a particular intervention. This will enable clinicians to select the best care\u00a0for a patient. A clinical pathway on the other hand is an optimal sequencing and timing of interventions not only by physicians but also nurses and other healthcare professionals. The sequencing is designed to minimize delays, optimize resource utilization and to maximize the quality of care. Clinical pathways differ from clinical guidelines and protocols as they are a set of practical treatment processes detailing how to implement clinical guidelines, including both clinical and non-clinical activities. Clinical guideline provides general recommendations, while clinical pathways provide specific task recommendations i.e., who should do the task, when and what will be the expected outcome for the care of the patient. Clinical pathway can also specify the variation i.e., if the task is not feasible, what is the alternative. Consensus statements are developed by an independent panel of experts, usually multidisciplinary, convened to review the research literature for the purpose of advancing the understanding of a health care issue. The expert panel develop consensus statement recommendations based on their review.<\/p>\n

Â鶹ֱ²¥ Approach of Clinical Pathway and Guideline Development<\/strong><\/p>\n

Some guideline developers follow the GRADE Approach using software like GRADEPro. GRADEPro is an evolving software and currently can be used for interventions, diagnosis and prognosis. This is usually used when developing de-novo recommendations. Others use the ADAPTE Process. The process was developed to take advantage of existing guidelines and avoid duplication efforts. The process provides a systematic approach to adapting recommendations from existing and quality guidelines that may address a specific health question for a specific condition that can used and applied to a defined scope and target setting. In the Â鶹ֱ²¥, we adopted this approach to address the unnecessary duplication of work. We make sure that the adapted recommendation addresses the specific clinical issues in family and community practice. Unfortunately, not all essential family and community practice interventions can be seen in current guideline recommendations. But guidance is still needed, so a de-novo approach to development of recommendation is still necessary. We therefore developed a mixed approach suitable to family and community practice as summarized by the steps below.<\/p>\n