MNT: RDN in Medical Team (2015)
What is the effectiveness of MNT (i.e., nutrition assessment, counseling and interventions) provided by a Registered Dietitian Nutritionist (RDN), when part of a healthcare team (i.e., transdisciplinary team, multi-disciplinary team)?
Strong evidence supports the effectiveness of nutrition interventions and counseling provided by a nutrition professional (registered dietitian nutritionist or equivalent) when part of a health care team. Compelling evidence from 36 studies supports the multi-disciplinary team approach (including a nutrition professional) to improve weight (-0.3kg to -25.9kg), BMI (-0.5kg/m2 to -14.6kg/m2), waist circumference (-1.0cm to -23.5cm), hip circumference (-2.8cm), fasting blood glucose (-1.6mg to -22mg per dL), HbA1c (-0.15% to -6%), fasting insulin (-3.7mcU to -7.7mcU per L), homeostatic model assessment-estimated insulin resistance (HOMA-IR; -1.0 units to -4.0 units), LDL-cholesterol (-6.0mg to -10mg per dL) and HDL-cholesterol (+2.0mg per dL) on a variety of health conditions (i.e., management of weight, eating disorders, diabetes, renal disease, amyotrophic lateral sclerosis (ALS), cardiovascular disease, osteoporosis).
- Grade I means there is Good/Strong evidence supporting the statement;
- Grade II is Fair;
- Grade III is Limited/Weak;
- Grade IV is Expert Opinion Only;
- Grade V is Not Assignable.
- High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
- Moderate (B) means we are moderately confident in the effect estimate;
- Low (C) means our confidence in the effect estimate is limited;
- Very Low (D) means we have very little confidence in the effect estimate.
- Ungraded means a grade is not assignable.
Evidence Summary: What is the effectiveness of MNT (i.e., nutrition assessment, counseling and interventions) provided by a Registered Dietitian Nutritionist (RDN) when part of a healthcare team (i.e., trans-disciplinary team, multi-disciplinary team)?
- Quality Rating Summary
For a summary of the Quality Rating results, click here.
- Bastiaens H, Sunaert P, Wens J, Sabbe B, Jenkins L, Nobels F, Snauwaert B, Van Royen P. Supporting diabetes self-management in primary care: Pilot-study of a group-based programme focusing on diet and exercise. Prim Care Diabetes. 2009; 3(2): 103-109.
- Battista MC, Labonte M, Menard J, Jean-Denis F, Houde G, Ardilouze JL, Perron P. Dietitian-coached management in combination with annual endocrinologist follow up improves global metabolic and cardiovascular health in diabetic participants after 24 months. Appl Physiol Nutr Metab. 2012; 37 (4): 610-620.
- Bayliss EA, Bhardwaja B, Ross C, Beck A, Lanese DM. Multidisciplinary team care may slow the rate of decline in renal function. Clin J Am Soc Nephrol. 2011; 6(4): 704-710.
- Beck A, Andersen UT, Leedo E, Jensen LL, Martins K, Quvang M, Rask KØ, Vedelspang A, Rønholt F. Does Adding a Dietician to the Liaison Team After Discharge of Geriatric Patients Improve Nutritional Outcome: A Randomised Controlled Trial. Clinical Rehabilitation, 2014; Dec 31. Epub. ILL number: 37101937.
- Bonarek-Hessamfar M, Benchimol D, Lauribe P, Hadjo A, Matis P, Dartigues JF, Bonnet J, Benchimo H. Multidisciplinary network in heart failure management in a community-based population: Results and benefits at two years. Int J Cardiol. 2009 May; 134(1): 120-122.
- Brancatisano A, Wahlroos S, Brancatisano R. Improvement in comorbid illness after placement of the Swedish Adjustable Gastric Band. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery; 4: S39-S46.
- Bray P, Cummings DM, Morrissey S, Thompson D, Holbert D, Wilson K, Lukosius E, Tanenberg R. Improved outcomes in diabetes care for rural African Americans. Annals of Family Medicine. 2013; 11 (2): 145-150.
- Burnham R, Day J, Dudley W. Multidisciplinary chronic pain management in a rural Canadian setting. Can J Rural Med. 2010; 15(1): 7-13.
- Casey J, Li CH, Johnson V, Sluman C, McClelland P. Multidisciplinary approach for prescriptive management of mineral and bone metabolism in chronic kidney disease: Development of a dietetic led protocol. J Ren Care. 2006; 32 (4): 187-191.
- Costa e Silva R, Pellanda L, Portal V, maciel P, Furquim A, Schaan B. Transdiciplinary approach to the follow-up of patients after myocardial infarction. Clinics, 2008; 63: 489-496.
- Cueto-Manzano AM, Martinex-Ramirez HR, Cortes-Sanabria L. Management of chronic kidney disease: Primary health-care setting, self-care and multidisciplinary approach. Clin Neph. 2010; 74(Suppl): S99-S104.
- Cueto-Manzano AM, Martinez-Ramirez HR, Cortes-Sanabria L. Comparison of primary health-care models in the management of chronic kidney disease. Kidney International Supplements. 2013; 3: 210-214.
- Duijzer G, Haveman-Nies A, Jansen S, ter Beek J, Hiddink G, Feskens E. Feasibility and potential impact of the adapted SLIM diabetes prevention intervention in a Dutch real-life setting: the SLIMMER pilot study. Patient Education and Counseling, 2014; 97: 101-107.
- Green BB, Anderson ML, Cook AJ, Catz S, Fishman PA, McClure JB, Reid RJ. e-Care for heart wellness: a feasibility trial to decrease blood pressure and cardiovascular risk. American Journal of Preventative Medicine, 2014; 46 (4): 368-377.
- Haskell WL, Berra K, Arias E, Christopherson D, Clark A, George J, Hyde S, Klieman L, Myll J. Multifactor cardiovascular disease risk reduction in medically underserved, high-risk patients. Am J Cardiol. 2006 Dec 1; 98 (11): 1,472-1,479. Epub 2006 Oct 12.
- Iwasa M, Iwata K, Hara N, Hattori A, Ishidome M, Sekoguchi-Fujikawa N, Mifuji-Moroka R, Sugimoto R, Fujita N, Kobayashi Y, Takei Y. Nutrition therapy using a multidisciplinary team improves survival rates in patients with liver cirrhosis. Nutr. 2013; 29: 1,418-1,421.
- Jhagroo R, Nakada S, Penniston K. Shared medical appointments for patients with kidney stones new to medical management decrease appointment wait time and increase patient knowledge. The Journal of Urology. 2013; 190: 1778-1784.
- Kellow, N. Evaluation of a rural community pharmacy-based waist management project: Bringing the program to the people. Aust J Prim Health. 2011; 17(1): 16-22.
- Lu X, Su C, Sun L, Chen W, Wang T. Implementing continuous quality improvement process in potassium management in peritoneal dialysis patients. Journal of Renal Nutrition. 2009; 19: 469-474.
- Majumdar SR, Guirguis LM, Toth EL, Lewanczuk RZ, Lee TK, Johnson JA. Controlled trial of a multifaceted intervention for improving quality of care for rural patients with type 2 diabetes. Diabetes Care, 2003; 26 (11): 3,061-3,066.
- Martin OJ, Wu WC, Taveira TH, Eaton CB, Sharma SC. Multidisciplinary group behavioral and pharmacologic intervention for cardiac risk reduction in diabetes: A pilot study. Diabetes Educ. 2007; 33(1): 118-127.
- Maruyama C, Kimura M, Okumura H, Hayashi K, Arao T. Effect of a worksite-based intervention program on metabolic parameters in middle-aged male white-collar workers: A randomized controlled trial. Prev Med. 2010; 51: 11-17.
- Mitchell SL, Klein J, Maduramente A. Assessing the impact of an eating disorders treatment team approach with college students. Eat Disord. 2014; 23: 45-59.
- Molenaar EA, van Ameijden EJ, Vergouwe Y, Grobbee DE, Numans ME. Effect of nutritional counselling and nutritional plus exercise counselling in overweight adults: A randomized trial in multidisciplinary primary care practice. Family Practice. 2010; 27: 143-150.
- Morisset A-S, Côté JA, Michaud A, et al. Dietary intakes in the nutritional management of gestational diabetes mellitus. Can J Diet Pract Res Publ Dietit Can Rev Can Prat Rech En Diététique Une Publ Diététistes Can. 2014;75(2):64-71
- Musacchio N, Lovagnini Scher A, Giancaterini A, et al. Impact of a chronic care model based on patient empowerment on the management of Type 2 diabetes: effects of the SINERGIA programme. Diabet Med J Br Diabet Assoc. 2011; 28 (6): 724-730. doi:10.1111/j.1464-5491.2011.03253.x.
- Nielsen D, Ryg J, Nissen N, Nielsen W, Knold B, Brixen K. Multidisciplinary patient education in groups increases knowledge on osteoporosis: A randomized controlled trial. Scand J Public Health. 2008; 36(4): 346-352.
- Orazio LK, Isbel NM, Armstrong KA, Tarnarskyj J, Johnson DW, Hale RE, Kaisar M, Banks MD, Hickman IJ. Evaluation of dietetic advice for modification of cardiovascular disease risk factors in renal transplant recipients. J Ren Nutr. 2011; 21 (6): 462-474.
- Siwinska J, Lesiak-Kalukin M, Przybylowski P, Sadowski J. Health behavior of patients after heart transplantation as an indicator of patient compliance. Transplant Proc. 2011; 43 (8): 3,086-3,088.
- Tang PC, Overhage JM, Chan AS, Brown NL, Aghighi B, Entwistle MP, Hui SL, Hyde SM, Klieman LH, Mitchell CJ, Perkins AJ, Qureshi LS, Waltimyer TA, Winters LJ, Young CY. Online disease management of diabetes: Engaging and motivating patients online with Enhanced Resources-Diabetes (EMPOWER-D), a randomized controlled trial. J AM Med Inform Assoc. 2013; 20: 526-534.
- Thanamayooran S, Rose C, Hirsch DJ. Effectiveness of a multidisciplinary kidney disease clinic in achieving treatment guideline targets. Nephrology Dialysis Transplantation, 2005; 20: 2,385-2,393.
- Trento M, Basile M, Borgo E, Grassi G, Scuntero P, Trinetta A, Cavallo F, Porta M. A randomised controlled clinical trial of nurse-, dietitian- and pedagogist-led Group Care for the management of Type 2 diabetes. J Endocrinol Invest. 2008; 31 (11): 1,038-1,042.
- Tungsanga K, Ratanakul C, Pooltavee W, Mahatanan N, Ayuthaya AIN, Rodpai S. Experience with prevention programs in Thailand. Kidney International. 2005; 67(Suppl 94): S68-S69.
- Van den Berg J, Kalmijn S, Lindeman E, Veldink J, de Visser M, Van der Graaff M, Wokke J, Van den Berg L. Multidisciplinary ALS care improves quality of life in patients with ALS. Neurology, 2005; 65: 1,264-1,267.
- Win AZ Ceresa C, Schafer AL, Mak, P, Stewart L. Importance of nutrition visits after gastric bypass surgery for American veterans, San Francisco, 2004–2010. Prev Chronic Dis. 2014; 11 :E226.
- Wong SKH, So WY, Yau PYP, Chan AKL, Lee S, Chan PN, Chow FCC, Chung SSC. Laparoscopic adjustable gastric banding for the treatment of morbidly obese patients: Early outcome in a Chinese cohort. Hong Kong Med J. 2005; 11: 20-29.
Search Plan and Results: MNT: Effectiveness of MNT when RDN is Team Member (2015)