1ISG-006 Closing inequity gaps in access to medical nutrition: a survey to understand barriers

<h3>Background and Importance</h3> A survey of market access experts of the Medical Nutrition International Industry was undertaken to understand the barriers contributing to inequity in optimal nutritional care in Europe. <h3>Aim and Objectives</h3> Disease-related malnutrition (DRM), an underdiagnosed, undertreated public health problem that affects 30–50% of hospital inpatients, results in poor health outcomes and higher costs.¹ Multidisciplinary care, including pharmacists, is essential to ensure optimal nutritional interventions.² Pharmacists are vital to multidisciplinary care coordination. Medical nutrition therapy is cost-effective and improves health outcomes, yet inequity exists in access.¹ This survey was conducted to address the limited insight across countries into the major barriers to implementation of equitable nutritional care beyond health technology assessment. <h3>Material and Methods</h3> An online survey was developed by the MNI, and members (n=6) participated between April and December 2024. Additional responses were included (National Industry Groups n=2; additional MNI members n=2). Results covered Croatia, France, Germany, Italy, Poland, Portugal, Spain, Switzerland, The Netherlands and the United Kingdom. Quantitative data were reported as percentages and qualitative data as key themes. <h3>Results</h3> Although screening for DRM was reported as being available in 80% of countries surveyed, it was mandatory in only 20% and often poorly implemented. Knowledge of nutritional care was described as inconsistent and specialty-dependent, with 56% reporting access to expert nutrition professionals as limited to hospital settings. Barriers identified included lack of funding, limited workforce availability and nutrition seen as a low priority. Although reimbursement of food for special medical purposes (FSMP) (medical nutrition products for oral or enteral nutrition) was reported by 90% of country respondents it varied by healthcare setting, and 50% reported that obtaining FSMP is ‘difficult/not easy’. Awareness of DRM amongst patients was reported as low, with difficulties navigating complex healthcare systems citied by 70% of country respondents as a key contributing factor to inequity. <h3>Conclusion and Relevance</h3> Knowledge of system-level barriers to nutritional care, beyond HTA, highlights actionable gaps within hospital practice. Hospital pharmacists can act as drivers of change. Through their roles in therapeutic committees, and care coordination, they can help embed medical nutrition into hospital standards and reduce access inequities. <h3>References and/or Acknowledgements</h3> 1. WHO-ESPEN 2023. https://www.who.int/europe/publications/i/item/WHO-EURO-2023-8931-48703-72392 2. Cederholm, <i>et al</i>. 2017. https://www.ncbi.nlm.nih.gov/pubmed/27642056 <h3>Conflict of Interest</h3> Corporate sponsored research or other substantive relationships: MNI represents the companies that were surveyed for this exercise.