Exploration and application of standardized clinical pathways of food for special medical purpose in medical institutions_West China Medical Journal

Authors：

WANG Mengyan ¹ , GONG Jie ¹ , YU Fengmei ¹ , CHEN Muxi ¹ , CHEN Xiaotian ² , XU Dafeng ³ , ZHENG Lihua ⁴ , SHI Lei ¹ , RAO Zhiyong ¹ ,  HU Wen ¹

1. Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Clinical Nutrition, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu 210008, P. R. China;
3. Department of Nutrition, Chenzhou First People’s Hospital, Chenzhou, Hunan 423000, P. R. China;
4. Department of Clinical Nutrition, the Second People’s Hospital of Yibin (West China Yibin Hospital, Sichuan University), Yibin, Sichuan 644000, P. R. China;

Corresponding?author：

HU Wen, Email: wendy_nutrition@163.com

Keywords：

Food for special medical purpose; clinical pathway; medical institution; management

DOI：

10.7507/1002-0179.202403088

Video：

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Objective To explore the generalizability and implementation effectiveness of standardized clinical pathways of food for special medical purpose (FSMP). Methods From November 10, 2023 to November 30, 2023, a pilot study for the standardized clinical pathway of FSMP in medical institutions was conducted at Nanjing Drum Tower Hospital (the Affiliated Hospital of Nanjing University Medical School), Chenzhou First People’s Hospital, and the Second People’s Hospital of Yibin. The hospitalized patients using FSMP in these three hospitals were continuously included to analyze the feasibility and effectiveness of the pathway. Results A total of 99 patients were included. The overall effect evaluation of the pathway showed that the proportion of convenient medical order (96.9%), timely delivery (100.0%), and easy storage (96.9%) were relatively high. The proportion of patients with good compliance was 88.9%, the proportion of patients who achieved treatment goals was 51.5%, and the proportion of patients who suspended the use of FSMP in advance was 19.2%. The incidence of gastrointestinal complications, metabolic complications, and infectious complications in patients were relatively low (<30%), and the median (lower quartile, upper quartile) satisfaction scores for patients, family members, and nurses were all 9.0 (8.0, 10.0) points. There was no statistically significant difference in the process evaluation indicators or satisfaction of FSMP clinical pathways between different prescribing personnel (P>0.05). There was no statistically significant difference in the process evaluation indicators or satisfaction of FSMP clinical pathways between different nutritional support methods (P>0.05). Conclusions The FSMP clinical pathway pilot has performed well in terms of convenience, compliance, satisfaction, with a low incidence of complications. The pathway is effective and safe, and can be widely applied.

Citation： WANG Mengyan, GONG Jie, YU Fengmei, CHEN Muxi, CHEN Xiaotian, XU Dafeng, ZHENG Lihua, SHI Lei, RAO Zhiyong, HU Wen. Exploration and application of standardized clinical pathways of food for special medical purpose in medical institutions. West China Medical Journal, 2024, 39(12): 1905-1910. doi: 10.7507/1002-0179.202403088 Copy

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16.	周子琪, 茍茂瓊, 胡雯, 等. 中國特殊醫學用途配方食品行業現況及探索. 腫瘤代謝與營養電子雜志, 2021, 8(4): 439-444.
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20.	李旭升, 蔣鑫煒, 孫建霞, 等. 特殊醫學用途配方食品的研究進展. 食品科學, 2017, 38(19): 255-260.

1. 國家食品藥品監督管理總局. 特殊醫學用途配方食品注冊管理辦法. 北京: 國家食品藥品監督管理總局, 2023.
2. 呂奕姝, 母東煜, 龔杰, 等. 我國 300 家二級以上醫療機構特殊醫學用途配方食品(FSMP)管理及臨床應用現狀調查. 中國食品衛生雜志, 2023, 35(3): 422-428.
3. 石磊, 楚辭, 饒志勇, 等. 特殊醫學用途配方食品臨床規范化管理的探索與思考. 重慶醫學, 2021, 50(7): 1238-1240.
4. 湖北省衛生健康委員會. 關于印發《湖北省醫療機構特殊醫學用途配方食品臨床應用管理規范(試行)》的通知. 武漢: 湖北省衛生健康委員會, 2020.
5. 江蘇省市場監管局, 江蘇省醫療保障局. 關于印發《江蘇省特殊醫學用途配方食品經營使用管理辦法(試行)》的通知. 南京: 江蘇省市場監管局, 2020.
6. Food Standards Australia New Zealand. Australia New Zealand food standards code standard 2.9.5 food for special medical purposes. Canberra: Food Standards Australia New Zealand, 2014.
7. 李佳桐, 呂奕姝, 母東煜, 等. 醫療機構合理使用特殊醫學用途配方食品(FSMP)綜合評價指標體系的構建. 中國循證醫學雜志, 2023, 23(11): 1323-1328.
8. 臨床營養項目專家工作組. 特殊醫學用途配方食品(FSMP)臨床管理專家共識(2021 版). 中國醫療管理科學, 2021, 11(4): 91-96.
9. 南通市市場監督管理局. 關于進一步規范醫療機構經營使用特殊醫學用途配方食品管理的通知. 南通: 南通市市場監督管理局, 2021.
10. 安徽省市場監督管理局, 安徽省衛生健康委員會. 關于印發《安徽省特殊醫學用途配方食品經營使用管理辦法》的通知. 合肥: 安徽省市場監督管理局, 2023.
11. 李晶晶, 楚辭, 蒲芳芳, 等. 四川省特殊醫學用途配方食品臨床應用不良反應分析. 現代預防醫學, 2019, 46(21): 3879-3881, 3891.
12. van Vliet IMY, Gomes-Neto AW, de Jong MFC, et al. High prevalence of malnutrition both on hospital admission and predischarge. Nutrition, 2020, 77: 110814.
13. Dataintelo. Food for special medical purpose (FSMP) market outlook 2032. Pune: Dataintelo, 2024.
14. 李雪梅, 石磊, 張勇勝, 等. 2019 年西部地區 230 家二級以上醫院臨床營養科現狀調查與分析. 檢驗醫學與臨床, 2020, 17(15): 2175-2178.
15. 李美英, 鄧少偉, 李雅慧, 等. 我國特殊醫學用途嬰兒配方食品現狀淺析. 食品與生物技術學報, 2021, 40(5): 104-111.
16. 周子琪, 茍茂瓊, 胡雯, 等. 中國特殊醫學用途配方食品行業現況及探索. 腫瘤代謝與營養電子雜志, 2021, 8(4): 439-444.
17. 石磊, 母東煜, 龔杰, 等. 應用德爾菲法初步完善特殊醫學用途配方食品綜合評價指標體系: 以 2 型糖尿病為例. 中國循證醫學雜志, 2020, 20(9): 1012-1019.
18. 孫玉鳳, 范蓓, 王艷, 等. 特殊醫學用途配方食品研究進展與展望. 生物產業技術, 2017(4): 70-75.
19. 邱斌, 徐同成, 劉麗娜, 等. 我國特殊醫學用途配方食品產業現狀. 中國食物與營養, 2015, 21(2): 32-33.
20. 李旭升, 蔣鑫煒, 孫建霞, 等. 特殊醫學用途配方食品的研究進展. 食品科學, 2017, 38(19): 255-260.

West China Medical Journal

Exploration and application of standardized clinical pathways of food for special medical purpose in medical institutions

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