Development of home artificial nutrition in Italy over a seven year period: 2005–2012

Background: In 2005, the Italian Society for Artificial Nutrition and Metabolism carried out a national survey on the prevalence of home artificial nutrition (HAN), enteral (HEN) and parenteral (HPN). A second survey was carried out in 2012 to investigate the development of HAN in Italy. Methods: The Local Health Care Units (LHCUs) were required to record the ongoing cases of HAN using a structured questionnaire. The point prevalence (n./million inhabitants) was analysed according to patient age and disease categories. Data were compared with those obtained in 2005. Results: Data were obtained from 65% of the LHCUs, representing 73% of the Italian population. The prevalence of HAN was 325.5 (90.3% adults, 84.6% HEN). As in 2005, a wide range of prevalence was observed among the administrative regions. The most frequent disease category for HPN was oncological in adults and intestinal failure in children; for HEN, it was neurological in both age groups. A positive correlation was observed between the regional prevalence of HAN and the regional population aging index (p = 0.018). The prevalence of HAN in 2012 was 66% higher than that in 2005. In the individual regions, a negative association was observed between the 2012% prevalence increase of HAN (2012:2005 ratio) and the HAN prevalence in 2005 (p = 0.020). Conclusions: A two-thirds increase in HAN prevalence was observed over seven years, probably due to improved HAN organisation and management in those regions which showed a low prevalence in 2005. Population aging seemed to be one of the main factors necessitating HAN.