Usefulness of the daily defined dose method to estimate trends in the consumption, costs and prevalence of the use of home enteral nutrition

Summary Background & aims To analyse the trends in consumption and costs of home enteral nutrition (HEN) products in Andalusia (Spain) and estimate the prevalence of HEN from 2000 to 2007. Methods Using the defined daily dose (DDD) method, we assigned a DDD to each type of diet, grouped as whole diets, supplements, modules and thickeners. The number of cases/10 6 inhabitants/day (CID) was calculated. Results The number of persons receiving HEN rose notably, from 66.4 CID in 2000 to 1315.4 in 2007. The number of persons with home enteral tube feeding has remained stable since 2003, at around 220 CID. HEN with oral nutritional supplements (ONS) increased exponentially, with a prevalence of 910 CID in 2007. The prevalence of HEN in 2007 was similar to that of other European countries. The costs associated with HEN rose from 1.3 million euros in 2000 to over 37 million euros in 2007, due to the progressive increase in the number of persons being prescribed HEN, especially ONS, and the incorporation of more expensive organ-specific formulas. Conclusions DDD is useful to indirectly estimate the prevalence of HEN and evaluate long-term trends in the prescription and costs of various HEN products.