Percutaneous endoscopic gastrostomy (PEG) feeding in elderly people with diabetes resident in nursing homes. 2013

R Gadsby
Warwick Medical School, University of Warwick CV4 7AL. R.Gadsby@warwick.ac.uk

OBJECTIVE To investigate the level of percutaneous endoscopic gastrostomy (PEG) feeding in elderly people with diabetes resident in Nursing homes in one area of the U.K., to describe their degree of disability, co-morbidities and to estimate medication costs of these residents. METHODS The data was collected from a retrospective case notes review of the 75 people with known diabetes who were resident in the 11 Nursing homes in the Coventry Teaching PCT in early 2010. RESULTS 14 residents (19% of the total sample) had PEG feeds in situ and one (1.3%) had a nasogastric feeding tube in situ. The 14 residents were taking a total of 80 daily medications, a mean of 5.7 daily medications per resident (range 3-10). The total medication costs for the regular medications for these 14 residents was 2410 euros per month giving a mean of 172 euros/month (range 14-935 euros per month). All of the 14 were recorded as being bedbound, having no speech and being doubly incontinent. CONCLUSIONS All 14 residents being PEG fed have severe levels of disability. Cerebro vascular accident and dementia are the main recorded co-morbidities. The most expensive monthly medication costs were for special order liquid medications, many for cardio vascular disease prevention, which may be considered as inappropriate in such severely disabled residents.

UI MeSH Term Description Entries
D007441 Intubation, Gastrointestinal The insertion of a tube into the stomach, intestines, or other portion of the gastrointestinal tract to allow for the passage of food products, etc. Intubation, Nasogastric,Gastrointestinal Intubation,Gastrointestinal Intubations,Intubations, Gastrointestinal,Intubations, Nasogastric,Nasogastric Intubation,Nasogastric Intubations
D007859 Learning Disabilities Conditions characterized by a significant discrepancy between an individual's perceived level of intellect and their ability to acquire new language and other cognitive skills. These may result from organic or psychological conditions. Relatively common subtypes include DYSLEXIA, DYSCALCULIA, and DYSGRAPHIA. Adolescent Learning Disabilities,Adult Learning Disabilities,Child Learning Disabilities,Developmental Academic Disability,Developmental Academic Disorder,Developmental Disabilities of Scholastic Skills,Learning Disabilities, Adolescent,Learning Disabilities, Child,Learning Disorders,Academic Disorder, Developmental,Adult Learning Disorders,Developmental Disorders of Scholastic Skills,Learning Disorders, Adult,Learning Disturbance,Scholastic Skills Development Disorders,Academic Disabilities, Developmental,Academic Disability, Developmental,Academic Disorders, Developmental,Adolescent Learning Disability,Adult Learning Disability,Adult Learning Disorder,Child Learning Disability,Developmental Academic Disabilities,Developmental Academic Disorders,Disabilities, Adolescent Learning,Disabilities, Adult Learning,Disabilities, Child Learning,Disabilities, Developmental Academic,Disabilities, Learning,Disability, Adolescent Learning,Disability, Adult Learning,Disability, Child Learning,Disability, Developmental Academic,Disability, Learning,Disorder, Learning,Disorders, Adult Learning,Disorders, Learning,Disturbance, Learning,Disturbances, Learning,Learning Disabilities, Adult,Learning Disability,Learning Disability, Adolescent,Learning Disability, Adult,Learning Disability, Child,Learning Disorder,Learning Disorder, Adult,Learning Disturbances
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009735 Nursing Homes Facilities which provide nursing supervision and limited medical care to persons who do not require hospitalization. Homes, Nursing,Nursing Home
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D003704 Dementia An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. Senile Paranoid Dementia,Amentia,Familial Dementia,Amentias,Dementia, Familial,Dementias,Dementias, Familial,Dementias, Senile Paranoid,Familial Dementias,Paranoid Dementia, Senile,Paranoid Dementias, Senile,Senile Paranoid Dementias
D003920 Diabetes Mellitus A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D004750 Enteral Nutrition Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes. Enteral Feeding,Force Feeding,Nutrition, Enteral,Tube Feeding,Gastric Feeding Tubes,Feeding Tube, Gastric,Feeding Tubes, Gastric,Feeding, Enteral,Feeding, Force,Feeding, Tube,Feedings, Force,Force Feedings,Gastric Feeding Tube,Tube, Gastric Feeding,Tubes, Gastric Feeding
D005774 Gastrostomy Creation of an artificial external opening into the stomach for nutritional support or gastrointestinal compression. Gastrostomies

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