Impact of post-discharge nutritional interventions on hospital readmissions: A systematic review

Abstract

BACKGROUND

Malnutrition is a common issue among hospitalised patients that contributes to increased risk of hospital readmission post-discharge. Current studies show that nutritional interventions improve recovery, but there is still limited literature on which specific type of nutritional intervention is most effective in reducing readmission rates.

AIM

To investigate the effectiveness of various post-discharge nutritional interventions in reducing hospital readmissions.

METHODS

We systematically searched PubMed, EMBASE, and other databases for relevant studies including patients discharged home after hospitalisation for acute illnesses, any nutritional intervention beyond usual care, and hospital readmission with any definition. Paediatric populations, elective admissions, and in-hospital nutritional interventions were excluded. Included studies were grouped by nutritional intervention type, with key findings extracted for qualitative synthesis. We also assessed risk of bias (Cochrane risk-of-bias 2 tool) and certainty of evidence (grading of recommendations assessment, development, and evaluation framework).

RESULTS

Thirteen studies involving 1543 participants were included and categorised into five subgroups: (1) Follow-up counselling (n = 7); (2) Pre-planned meals (n = 1); (3) Individualised nutrition care plans (n = 3); (4) Oral nutritional supplementation with whey protein (n = 1); and (5) Diet supplementation with watermelon (n = 1). Evidence for follow-up counselling was mixed, with only 3 of 7 studies reporting reduced 3-month and 6-month readmission rates. Studies on individualised nutrition care plans also show mixed results, with only 1 of 3 studies observing reduced 6-month readmission rates. The single study of oral nutritional supplementation with whey protein also saw a reduction of 1-month readmission rates. The remaining single studies of pre-planned meals and diet supplementation with watermelon did not demonstrate clear benefit.

CONCLUSION

Some nutritional interventions show potential in reducing readmission rates but generalisability is limited by inconsistent findings, inadequate sample sizes, and risk of bias. Further research with larger, high-quality randomised controlled trials is required to strengthen the body of evidence.

Keywords: Adults; Acute; Discharge; Nutritional intervention; Nutritional support; Nutritional supplementation; Nutrition therapy; Readmission

Core Tip: Unplanned hospital readmissions are costly and often preventable. This systematic review synthesised 13 trials assessing nutritional interventions delivered after discharge, including dietary counselling, oral nutritional supplements, and structured follow-up. Results were mixed. Comprehensive and sustained strategies, especially those involving dietitians and caregiver support, were most effective at reducing readmissions in older adults. Even when readmission was unaffected, improvements in nutritional status, quality of life, and physical function were noted. Integrating dietitians into discharge planning may represent a cost-effective strategy to reduce unplanned hospital readmissions and improve patient outcomes.