Patient Is Malnourished and Requires Ons

Oral Nutritional Supplements (ONS) Prescribing Guidelines for Primary Care 2012

Patient is malnourished and requires ONS / / Can patient swallow safely? / YES
/ Does the patient like milk-tasting products? / YES
/ Consider2 prescribing a milk based product
(initially 1-2 per day in addition to oral intake)

NO NO

Consider1 prescribing semi-solid or pre-thickened product
(initially 1-2 per day in addition to oral intake) / Consider2 prescribing a fruit based product
(initially 1-2 per day in addition to oral intake) / Is the patient/carer able to buy milk
and mix a powder?
(initially 1-2 sachets/bottles per day in addition to oral intake )

YES NO

Consider2 prescribing:
Complan® Shake
Complan® Foods Ltd / Consider2 prescribing a ready prepared ONS
Company(in alphabetical order ) / semi-solid products / pre-thickened
products / fruit –based products / Sweet milk tasting style / Savoury / Sweet milk tasting style
with Fibre*
Abbott / Ensure Plus Creme / Ensure Plus Juice / Ensure Plus High Energy Milkshake style
Ensure Plus Yogurt style** / Ensure Plus
Savoury / Ensure Plus
with fibre
Fresenius Kabi / Fresubin creme / Fresubin Thickened / ProvideXtra® drink / Fresubin® energy Drink / Savoury Multifibre / Fresubin® energy fibre drink
Nestle / Resource® Dessert Energy
Resource® Dessert Fruit / Resource Thickened drinks / N/A / Resource® Energy / N/A / N/A
Nutricia / Forticreme Complete
Fortisip Fruit Dessert / Nutilis complete / Fortijuce / Fortisip Bottle
Fortisip Compact -
for patients who require smaller volumes***
Fortisip Yoghurt Style ** / N/A / Fortisip Compact Fibre - for patients who require smaller volumes***
Vitaflo / N/A / N/A / N/A / Vitasavoury 200 & 300 / N/A

*Useful for individuals with constipation or clinical conditions affecting bowel ** Most useful for individuals who have altered taste and require a sharper flavour *** remember to consider overall fluid intake 1 If patients have swallowing difficulties consider referral to a speech and language therapist. 2 Refer patients to the dietitian initially if: they are on a special diet with unstable underlying disease e.g. diabetes, GI disorders, renal, liver, they have a grade 3 or 4 pressure ulcer or they have dysphagia and have been referred to the Speech and Language Therapist.