Priority Setting for Adult Malnutrition and Nutritional Screening in Healthcare: A James Lind Alliance

For which topic were research priorities identified?

adult malnutrition and nutritional screening

In which location was the research priority setting conducted?

Europe - United Kingdom

Why was it conducted at all?

Malnutrition is one the greatest global health challenges of our generation, leading to the increased utilisation of healthcare resources, as well as morbidity and mortality. Research has primarily been driven by industry, academia and clinical working groups and has had little involvement from patients and carers.

What was the objective?

to establish a priority setting partnership allowing patients, carers and healthcare professionals an opportunity to influence the research agenda

What was the outcome?

a ranking list of 10 research questions

How long did the research prioritization take?

February 2018 - June 2019

Which methods were used to identify research priorities?

JLA method

How were the priorities for research identified exactly?

Step 1: setting up PSP: forming steering group, agreement of scope and protocol. Step 2: collecting uncertainties: gathering evidence from literature and survey, 1128 uncertainty questions submitted via survey. Step 3: data processing: grouping questions, combining similar questions, formulating indicative questions, list of 81 indicative questions generated. Step 4: interim ranking: via survey, participants were asked to select their 10 most important indicative questions, to ensure equal weighting votes were split into group of patients, carers and patient representatives and group of healthcare professionals, resulting in final list of 26 questions moving forward. Step 5: final prioritization: workshop: series of small group discussions with nominal group technique and small group rankings

Which stakeholders took part?

Patients, carers and healthcare professionals. Survey: 268 participants: 194 professionals and 74 patients and carers. Interim ranking: 71 participants: 53 healthcare professionals and 18 patients and carers. Workshop: 17 participants: 5 dietitians, a speech and language therapist, a policy officer for the BDA, a nurse practitioners, a dietetic assistant, a macmillan project dietitian, 2 voluntary sector representatives, 3 patients and 2 carers; 7 people attended separate meeting for independent living service: 4 community dietitians, a registered nutritionist, a member of the administration team and a team member with experience of malnutrition as a carer.

How were stakeholders recruited?

Potential healthcare and charitable partner organizations, which could provide access to a wide range of participants, were identified and invited to be involved in the PSP. Partners promoted the survey: it was advertised online through ‘People in Research', ‘Salford Citizen Scientist', ‘University of Manchester' and a Twitter account.

Were stakeholders actively involved or did they just participate?

Stakeholders not only participated but were also actively involved in the research prioritization process: They were part of a steering group. The steering group consisted of 4 dietitians, 2 nutrition nurse specialists, a voluntary sector representative, a gastroenterologist, 2 nutrition and healthcare professionals and lecturers, a patient representative, 2 patients with experience of malnutrition and 2 carers. The members created the survey, and were involved in data processing and interim ranking. The members met quarterly throughout the project.