Heart failure patient at home with medically tailored meal and telehealth nutrition support.

Heart Failure Care at Home: What Medically Tailored Meals Really Deliver

Food-as-Medicine • Cardiometabolic Care

A 2023 systematic review synthesized MTM programs for HF, showing promising reductions in readmissions and nutrition gains—plus the key implementation gaps to address.

Quick take for physicians: MTMs may lower readmissions and improve nutritional status in HF. The 2023 review highlights encouraging signals but calls for larger, longer RCTs and tighter implementation (logistics, payer clarity, RD follow-up).

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What the review covered

The review synthesized randomized and prospective studies of medically tailored meals for adults with heart failure, focusing on readmissions, mortality, nutritional status, and patient-reported outcomes.

Programs ranged from 4–12 weeks, with varied meal counts and RD support.
PubMed record ›
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Key findings

Readmissions: Several studies reported fewer HF-related readmissions among MTM recipients (effect sizes varied; many studies were underpowered).
Nutritional status: Improvements in calorie/protein intake, weight stability, and malnutrition risk scores.
Quality of life: Some gains in energy and function, though data remain limited.
Mortality: Insufficient evidence—few trials reported hard endpoints.

Clinical implications

Transitions of care: Early post-discharge is a high-yield window for MTMs to support adherence, sodium control, and energy/protein adequacy.
Targeting: Prioritize patients with food insecurity, malnutrition risk, or IADL limitations.
Team-based: Pair meals with RD telehealth and simple self-monitoring (weight/BP).
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Implementation lessons

Make MTMs stick in HF programs

EHR integration: Discharge order-set prompt for MTM referral + RD follow-ups.
Logistics: Ensure reliable delivery windows and cold-chain integrity.
Payer pathways: Clarify MA supplemental benefits, Medicaid pilots, and HSA/FSA rails.
Measurement: Track 30/90-day readmissions, ED visits, malnutrition scores, and patient-reported energy.
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FAQs

Which HF patients should get MTMs?
Recently discharged patients with malnutrition risk, documented food insecurity, or functional barriers to shopping/cooking.
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How many meals and how long?
Commonly 7–14 meals per week for 4–12 weeks post-discharge; extend based on adherence, risk, and outcomes.
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What outcomes prove value?
30/90-day readmissions and ED visits, weight stability, malnutrition scores, and patient-reported energy/function.

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