V. Nutricia, Zoetermeer, The Netherlands) providing 2.1 MJ (500 kcal) and 40 g of protein per 500 ml. Furthermore, the dietician made arrangements to solve any problems, e.g. feeding difficulties, in collaboration with the hospital medical and nursing

staff. At the second visit during hospitalization, 7–8 days after surgery, the dietician evaluated food intake and the consumption of the ONS using a 24-h recall and gave individually tailored advice to optimize selleckchem dietary intake. Furthermore, the transfer of the patient to the rehabilitation centre or the patient’s home was prepared by evaluating the patient’s physical restrictions with regard to nutritional care, i.e. purchasing food products and the preparation of meals, and by making arrangements to enable adequate food intake, e.g. support of informal caregivers and delivery of information on meal services. After hospital discharge, the dietician visited each patient VRT752271 mouse three times (1, 2 and 6 weeks after discharge) at the patient’s home or in the rehabilitation centre (whatever was applicable) in order to evaluate dietary intake including the intake of the ONS, to evaluate possible bottlenecks in nutritional care at home (e.g. MK5108 shopping, cooking) and to give dietary advice as needed. In addition, in-between these home visits, weekly telephone calls were made (3, 4, 5, 8 and 10 weeks after discharge) to evaluate dietary

intake (including the ONS) by 24-h recall. If necessary, a telephone call was replaced by a home visit. Usual care Patients allocated to the control group received usual care as provided in the hospital, rehabilitation clinic or at home, i.e. dietetic

care or nutritional supplements were only provided on demand of the medical doctor in charge. In the control group, ten patients (13%) received ONS and 18 patients (23%) received dietetic counseling. Economic evaluation Effect measures Weight At baseline, self-reported weight was used, because patients were not able to stand on a weighing scale because of hip fracture. At 3 months postoperatively, weight was measured using an electronic weighing scale (Seca 862, Seca Ltd, Birmingham, Ribonucleotide reductase UK). The difference in weight in kilograms between baseline and 3 months postoperatively was calculated and used to evaluate the effectiveness of the nutritional intervention. Quality adjusted life years Quality of Life was estimated at baseline and at 3 and 6 months postoperatively using the Dutch version of EuroQoL (EQ-5D-3 L) [27–29]. In the EuroQoL, the patient was asked to make a statement on the degree of problems (no problem, some problems or major problems) he/she experienced on the dimensions of mobility, self-care, usual activities, pain or discomfort and anxiety or depression. The degree of problems on each dimension were combined to a health state.