People who live in care homes are more at risk of malnutrition. Malnutrition harms their health, reduces their quality of life, and increases the risk of falls and infections. They need more GP and hospital appointments, and experience slow recovery from illness.

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Treating malnutrition cost a huge amount, estimated at over £11 billion a year in health and social care.

Currently, the recommended first approach for treating malnutrition in care homes is to provide food with extra protein, calories, vitamins, and minerals (fortified foods).

If that is not enough, the second approach is to use powdered or liquid supplements (prescribed oral nutritional supplements) containing a balance of energy, protein, vitamins and minerals.

However, we know that these recommendations are not always followed, and associated health and care costs continue to rise. Prescribed oral nutritional supplements are often used as the first approach and can be wasted if not liked by residents or if care homes lack proper guidance.

Testing different approaches to treating malnutrition

REFRESH aims to test how best to treat malnutrition in older care home residents. We will recruit 90 care homes and 1,530 residents at risk of malnutrition. Each care home will be randomly put into one group and their residents will receive this approach to treating any malnutrition:

  • Prescribed oral nutritional supplements
  • Fortified food and drink
  • Routine practice (treatment as usual)

We will collect information from residents at the start of the trial, and then at six and 12 months after the start, including quality of life, food intake, appetite, muscle strength, weight, activities of daily living, and costs of the use of prescribed oral nutritional supplements and NHS services.

Those who often do not have the opportunity to take part in research – for example, those from ethnic minority groups and people who depend on others to make their decisions – will be included.

The REFRESH trial is due to start on 1st January 2025. For further information, please contact [email protected]