This case study showcases AYMES Actagain 2.4 Daily (formerly AYMES ActaGain 600)* and highlights some of the clinical outcomes experienced by Jean,** an 82 year-old woman with a complex medical history, following a switch to Actagain 2.4 Daily
Background
Jean was recruited to a 33-day acceptability study of AYMES’s product, Actagain 2.4 Daily. Jean is an 82-year-old lady, living in a care home with a past medical history of Parkinson’s disease, osteoporosis, hypertension, knee replacement, partial thyroidectomy, osteoarthritis and type 2 diabetes.
When Jean was recruited into our acceptability study, she weighed 47.5kg, corresponding to a body mass index (BMI) of 18.1kg/m2. Based on the Malnutrition Universal Screening Tool (MUST), she was classified as high risk of malnutrition, with a MUST score of two.
Management
To start with, Jean was prescribed a leading competitor Oral Nutrition Supplement (ONS) product twice a day, providing her with 600kcals and 24g protein. However, Jean’s compliance was poor and she only managed 67% of her supplements each day. Additionally, she reported a couple of episodes of abdominal pain while taking this supplement.
As part of the study, Jean was switched to Actagain 2.4 Daily once daily, split into four doses throughout the day. ActaGain 600, with its 2.4 kcal/ml formulation, delivered the same total daily energy and protein intake of 600 kcal and 24g of protein. Following this switch, her ONS compliance increased to 97%; she tolerated Actagain 2.4 Daily well and reported that compared to the previous supplement, Actagain 2.4 Daily had a ‘much better taste’. Jean rated Actagain 2.4 Daily’s appearance, acceptability, convenience to consume, taste and consistency as a four out of five after only one week and again at the end of the 33-day study.
Outcomes
Jean’s improved ONS compliance led to her being able to meet her nutritional requirements and as a result, her weight increased from 47.5kg to 48.1kg. Although her MUST score remained at two, Jean’s BMI increased to 18.3kg/m2. Following the switch to Actagain 2.4 Daily, she didn’t experience any abdominal pain.
Discussion
Jean’s story highlights the important role that ONS can play in those who are at high risk of malnutrition. As shown in this case study, ONS compliance is key to meeting nutritional requirements and ultimately achieving weight gain. Evidence suggests that allowing patients to consume their ONS in smaller, shot-style doses throughout the day may help improve compliance and support nutritional goals.1 In this case, Actagain 2.4 Daily split into four doses throughout the day provided a convenient, acceptable and tasty supplement for Jean. Alongside person-centred food-first strategies, appropriate and well-tolerated ONS can play a valuable role in helping older adults meet their nutritional requirements and improve health outcomes.
Footnotes
*Since this case study was initially written, ActaGain 600 has rebranded to Actagain 2.4 Daily.
** Patient’s name has been changed to ensure anonymity
