Epidemiology of home parenteral nutrition in adults in France

Objective. - French epidemiological data regarding home parenteral nutrition (HPN) are not well known and give rise to imprecise estimates. This study targets the adult population to obtain accurate data especially by trying to determine the pathologies associated with the HPN. Methods. - A retrospective and observational study covering the year 2017 (from 01/01 to 31/12/2017) has been carried out, with the data of the adult population aged over 15 years, by defining three age groups: 15-39 years, 40-64 years, 65 years and over. The databases of the health insurance allowed to obtain on the one hand, the number of patients who started HPN and on the other hand, the number of patients followed in HPN. The target population (health insurance beneficiary population) being known, these data allowed to calculate incidence and prevalence, respectively. The data were also crossed with the thirty long-term diseases file of health national insurance (ALD 30), allowing patients to be classified into six categories: cancer, neurology, chronic intestinal inflammatory diseases, organ deficiency, others pathologies, and undetermined pathologies.Results. - Data from 92.1% of adult national population were obtained, totaling 50.8 millions adults. The average incidence and prevalence of HPN were estimated at 20.8/100,000 inhabitants/yr and 26.0/100,000 inhabitants, respectively. Prevalence of long-term HPN (> 12 weeks) was 6.0/100,000 inhabitants. The main pathology was cancer. Inflammatory bowel diseases were the second cause of HPN in the age range 15-39 years.Conclusion. - This is the first national study on the epidemiology of HPN in adults in France, based on data from health insurance. The projection of these figures to the entire French adult population leads to an estimate of around 14,300 patients per year benefiting from national health insurance for HPN, mainly for cancer diseases.