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The University of Southampton
Southampton Clinical Trials Unit


Trial Name

Screen and TREAt for Malnutrition (STREAM) 


About 20% of older people living at home are at risk of malnutrition. In particular poor appetite is an important risk factor for malnutrition and for weight loss, which is in turn a risk factor for the development of infections, hospital admissions and even longer term mortality. This may be because they are not getting enough to eat, or because they are not eating enough of the right food.

An intervention (‘Eat well, feel well, stay well’) has been developed, to help doctors and nurses in general practice to check if older adults who live at home are at risk of malnutrition. They can then offer support to those who need it. This includes booklets and other materials for older adults, and a support tool for health professionals. The support tool includes guidance about when to see patients, and for those more severely at risk when to use oral nutritional supplements.

The intervention was developed by experts who looked at previous literature to find what helps or hinders older adults eating well, and what is likely to work best in general practice. The intervention was improved after feedback from people aged over 65 years, patients and healthcare professionals.

This study aims to assess the effectiveness of the intervention. All patients get a brief intervention with patient booklets and follow-up, but individuals who are at much greater risk will have the brief intervention plus oral nutritional supplements (ONS) for short spells when they are unwell. The study will also follow a group of patients who have the usual care that is provided by their doctors’ surgery.



A phase 3/4 randomised controlled Intervention study with approximately 100 sites (GP surgeries).


Patients aged ≥ 75 years and have one or more of the following major medical or social problem(s) increasing nutritional risk:


Chief Investigator: Professor Paul Little

Trial Contact: Jo Kelly (

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