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Dr Anne Holdoway, DHealth, BSc, RD, FBDA
Dr Sanjay Suman, MD, FRCP
Dr Ione de Brito-Ashurst, RD, PhD
November 2022 | 57 mins
In this course, you’ll learn about the causes of frailty, including malnutrition and muscle loss, as well as methodologies for screening, diagnosis and intervention.
Once you have watched this video, please remember to complete your self-reflective notes to contribute towards your continuing professional development. You will then be able to access your Certificate of Completion.
Identify the multifactorial aetiology of frailty, including malnutrition and sarcopenia as major risk factors.
Describe the factors that contribute to malnutrition in oncology and the impact of muscle loss in treatment and recovery.
Explain the importance of functional parameters and introduce practical tools for screening and diagnosing muscle loss.
Consultant dietitian, Education Office BAPEN, Chair ‘Managing Adult Malnutrition in the Community’ National Panel, Bath
Anne's 35-year career as a dietitian includes senior positions in the medical nutrition industry and clinical dietetics. Combining teaching and consultancy work with clinical practice, Anne currently utilises her skillset to provide direct care, education and resources on the management of long-term conditions, drawing on expertise gained in gastroenterology, oncology, palliative care, nutrition support, intensive care, neurorehabilitation, and surgery.
Over the past 15 years, Anne has dedicated considerable personal time to support national organisations including the National Institute for Health and Care Excellence (NICE), the Royal College of Physicians and the Royal College of GPs and has held numerous positions in the British Dietetic Association (BDA) including several terms as Chair of PENG and a term Chair Elect for the BDA in which she drove the outcome agenda and campaigned for the recognition of the value of dietitians in primary care.
Anne has also worked in numerous committees and within the Executive team for the British Association for Parenteral and Enteral Nutrition (BAPEN). ln recognition of her contribution to the field of nutrition she was awarded the prestigious fellowship of the BDA in 2016 and the BAPEN John Lennard-Jones medal in 2020.
As Chair of the UK multi-professional ‘Managing Adult Malnutrition in the Community’ (Malnutrition Pathway) advisory board, Anne has led on the development of free to access resources to support health and care professionals, patients, and carers in identifying, treating, and preventing disease-related malnutrition in the community.
Anne's doctorate focused on the role of nutrition in palliative care (as perceived by patients, carers, and healthcare professionals), and working part-time in the hospice and community settings Anne, along with colleagues, introduced a new approach to integrating nutrition into palliative care management, working closely with the Physiotherapy team to achieve a dual approach to nutrition and activity. Anne regularly presents at national and international events, has numerous publications under her belt and is Editor for Complete Nutrition through which she aims to spread the word on the role of nutrition as a modifiable component in modern health care to influence person-centred outcomes.
Consultant Geriatrician & Clinical Director, Medway NHS Foundation Trust, Kent
Sanjay Suman is the Clinical Director of the Therapies and Older Persons Programme at Medway NHS Foundation Trust in Kent. He was appointed as Consultant Geriatrician in 2007 and is a Fellow of Royal College of Physicians, London. Sanjay has special interest in frailty, sarcopenia, falls and syncope in elderly patients and runs an orthogeriatric service for fracture neck of femur pathway at Medway NHS Foundation Trust.
In his clinical director role he has developed a number of bespoke frailty focused assessment pathways such as the acute frailty unit and falls and syncope clinic for elderly. In the community, he has supported the development of a number of services such as care home support services, geriatric led MDT meetings in the community to name a few. He has been a recipient of Academic Health Sciences Network (Kent, Sussex and Surrey) Leadership and Innovation award for excellence in out of hospital care category 2017.
As a subject matter expert, Sanjay has delivered a number of keynote lectures on frailty, sarcopenia, polypharmacy reduction and falls at national and international conferences. He is passionate about improving the reversible components of frailty, such as nutritional status and polypharmacy reduction, contributing to improving clinical outcomes for frail individuals, both in primary and secondary care.
Head of Therapies & Rehabilitation, Royal Marsden NHS Foundation Trust, London
Ione is a dietitian and most of her recent clinical work has been in critical care. This has led to her active research interest in prevention and management of muscle mass decline. However, her research as part of her master’s and PhD has been around renal nutrition. She carried out her master’s research in patients’ renal nutrition education looking at improving phosphate management.
This was followed by a trial in bicarbonate supplementation that was published in an USA journal, won a European prize for significant contribution to the renal field and led to changes in the American and European renal nutrition recommendations.
Ione’s PhD followed this – A dietary salt intervention to reduce blood pressure in the Bangladeshi chronic kidney disease patients. Her work aimed to bridge the gap between the acute and community sector in the renal care of this patient group and to reduce health inequalities.
Ione is currently part of the European Society Parenteral Enteral Nutrition (ESPEN) Life Long Learning Faculty teaching group. She also works with the Care Quality Commission (CQC) of NHS England as a specialist advisor. Despite the leadership role, Ione is still passionate about nutrition and critical care and works closely co-supervising Masters and PhDs at Brazilian Universities. Ione won the ‘Florence Nightingale Leadership’ scholarship award in 2016, the only allied health professional in the nursing group.
Ione joined the London Clinical Senate Council in May 2019.
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