This clinical nutrition course, organized into ten thematic sessions, enables master’s students in pharmacy to gain an in-depth understanding of both normal and pathological nutrition.
Upon completion of this clinical nutrition course, students will be able to define and apply the fundamental principles of clinical nutrition within the Belgian pharmaceutical context. They will be proficient in assessing patients’ nutritional status using appropriate diagnostic tools and will be able to recognize the clinical signs of malnutrition. They will understand the mechanisms of macro- and micronutrient absorption and will be able to recognize the clinical and biological manifestations associated with deficiency or excess states. They will be able to design individualized interventions aimed at correcting these imbalances and restoring homeostasis.
Students will be able to distinguish between different nutritional approaches (preventive, curative, palliative) and calculate the energy, fluid, and nitrogen requirements specific to each patient.
Attention will also be given to the interactions between enteral and parenteral nutrition on the one hand, and medications on the other.
Future pharmacists will be able to advise on and monitor the use of various forms of artificial nutrition, pharmaconutrients, vitamins, trace elements, and plant extracts available in pharmacies, while incorporating the INAMI’s reimbursement criteria into their practice.
They will be able to tailor their nutritional recommendations to specific populations (geriatrics, pediatrics, pregnancy, chronic conditions, etc.) and effectively coordinate the transition between the hospital and the pharmacy.
Finally, they will incorporate emerging concepts in personalized nutrition, nutrigenetics, and the role of the microbiome into their future professional practice.
The program is primarily designed to provide students with a solid foundation of knowledge in clinical nutrition, while developing their practical skills to apply this knowledge to patient care.
This first objective aims to lay the solid foundation necessary for understanding clinical nutrition as a therapeutic discipline. Students will learn to distinguish between clinical nutrition and preventive nutrition by understanding their specific areas of application in hospital and pharmacy settings. They will gain in-depth knowledge of recommended nutritional intakes and the composition of a balanced diet, while mastering the calculation of individualized fluid, energy, and nitrogen requirements. Learning about the mechanisms of digestion, absorption, and metabolism of macronutrients will provide an essential foundation for understanding nutritional disorders.
Students will also develop practical skills in using nutritional assessment tools, including the interpretation of biomarkers (albumin, prealbumin, CRP, …) and the application of validated screening scores.
This theoretical training will be supplemented by an introduction to predictive scores and the principles of personalized medicine, preparing future pharmacists for an individualized approach to nutritional care.
By the end of this part of the course, future pharmacists will have the scientific and technical tools necessary to contribute effectively to nutritional care, in accordance with current recommendations. The goal is to train professionals capable of identifying, assessing, and quantifying nutritional needs in various clinical situations.
2nd Objective: To develop expertise in therapeutic nutrition and pharmaconutrition
The second objective of the course is to prepare students to fulfill their role as pharmacists throughout the patient’s care continuum by incorporating the nutritional dimension, while making them aware of the pivotal role that pharmacists play within the multidisciplinary team.
This objective will focus on the acquisition of in-depth expertise in therapeutic nutrition, particularly in complex clinical situations. Students will learn to master the various modalities of artificial nutrition, ranging from enteral nutrition (selection of polymeric, oligomeric, and specialized formulas) to parenteral nutrition.
They will develop an understanding of the interactions between nutrition and medications, including physicochemical incompatibilities and pharmacokinetic changes induced by nutritional status or genetic predispositions.
Learning about enhanced recovery after surgery (ERAS) protocols and prehabilitation concepts will enable students to integrate the nutritional dimension into perioperative care pathways.
Special attention will be given to the nutritional management of chronic conditions (diabetes, cardiovascular diseases, cancers, etc.) and acute conditions (renal failure, digestive disorders, etc.), taking into account the specific pathophysiological characteristics of each condition.
Students will also acquire the skills necessary to advise on and monitor the use of oral nutritional supplements, phytonutrients, vitamins, trace elements, and plant extracts available in community pharmacies, while incorporating the INAMI reimbursement criteria into their practice.
This objective aims to train pharmacists capable of optimizing nutritional care in all clinical situations encountered, both in hospitals and in community pharmacies, as well as managing the hospital-pharmacy transition to ensure continuity of nutritional care.
Furthermore, future pharmacists are encouraged to incorporate the prevention and screening of nutritional disorders and micronutrient deficiencies or excesses into their daily practice, particularly by identifying at-risk patients in community pharmacies and participating in nutritional education campaigns.
Third objective: Integrate personalized nutrition and therapeutic innovations into pharmaceutical practice
The third objective prepares students for current and future developments in clinical nutrition, with an emphasis on personalized therapeutic approaches.
Students will explore the mechanisms of hunger and satiety, including the role of regulatory hormones (leptin, ghrelin, GLP-1), to better understand metabolic dysregulation.
They will develop expertise in the nutritional management of specific populations (geriatrics, pediatrics, pregnancy, athletes), tailoring their recommendations to the specific physiological needs of each group.
By learning the concepts of nutrigenetics and nutrigenomics, future pharmacists will be able to incorporate genetic factors into the development of their nutritional and supplementation recommendations.
Students will also gain an in-depth understanding of the role of the gut microbiota and the therapeutic use of prebiotics, probiotics, and postbiotics.
The program will include the study of plant extracts and herbal medical devices that modulate the body’s response to food.
Finally, the ethical aspects of nutrition in palliative care will be addressed, preparing students for the complex dilemmas of end-of-life care and respect for patient autonomy.
· Description des objectifs du cours
o Définir la nutrition clinique et ses domaines d’applications
o Place du pharmacien dans le trajet de soin
o Différence entre nutrition préventive, curative et palliative
· Description d’une alimentation « normale ».
o Apports nutritionnels recommandés
o Composition d’une alimentation équilibrée
o Besoins hydriques, énergétiques et azotés
o Rappels des notions de base de digestion, absorption et métabolisme des glucides, lipides et protéines
· Physiologie et Physiopathologie :
o Mécanismes de la faim et de la satiété (
o Épidémiologie : de la dénutrition et de l’obésité en Europe
o Introduction sur les scores prédictifs (bases statistiques) et la médecine personnalisée
o Outils d’évaluations de l’état nutritionnel du patient, en ce compris les aspects cliniques.
o Bénéfices de la nutrition clinique ou « pourquoi nourrir le patient malade ? »
o EPSEN Guidelines
· Les différentes formes de nutrition clinique :
o Macronutriments et micronutriments
o Alimentation enrichie et compléments nutritionnels oraux (CNO)
o Nutrition entérale
o Nutrition parentérale
o La nutrition aux soins intensifs
o Administration des médicaments par une sonde naso-gastrique
· La place de la nutrition clinique en pratique hospitalière :
o Interactions entre nutrition et médicaments
o Concept de réhabilitation améliorée après chirurgie (RAAC-ERAS)
o Concept de préhabilitation
o Concept d’hospitalisation à domicile (HAD) et de nutrition artificielle à domicile (NAD)
· Nutrition chez les populations spécifiques :
o Gériatrie
o Pédiatrie
o Grossesse
o Sportifs et compléments alimentaires
o Patient chirurgical
o …
· Nutrition et pathologie chroniques :
o Diabète
o Maladies cardiovasculaires
o Cancers et cachexie sévère
o Obésité et surpoids
o Endométriose
o Syndrome des ovaires polykystiques
o Insuffisants rénaux chroniques
o Neurologiques
o Les patients avec des polymorbidités
o Pathologies digestives, hépatiques et pancréatiques
o …
· Le dilemme éthique de nutrition clinique dans la médecine palliative
· Le relais entre l’hôpital et l’officine de ville (prescription, matériel, suivi, …)
· Nutrition personnalisée
· Nutrigénétique et nutrigénomique
· Epigénétique et nutrition
· Microbiote (Pré-biotique, Pro-biotique, Post-biotique)
· Plante, extraits végétaux et Dispositifs Médicaux à base de plantes
The 20 hours of instruction will be delivered in a lecture format. Sixteen of the 20 hours will be taught by Mr. Eric Deflandre (anesthesiologist and intensive care specialist), and the remaining four hours by Mr. Anthony Sternotte (pharmacist). The course will be primarily hands-on to help future pharmacists navigate the vast and complex field of nutrition.
The questions will be distributed fairly based on the number of class hours taught:
• Questions related to Mr. Deflandre’s lectures will account for 80% of the exam questions and may include multiple-choice questions, open-ended questions, and practical clinical case studies.
• Questions related to Mr. Anthony Sternotte’s lectures will account for 20% of the exam questions and …
• The two parts of the course (Mr. Deflandre and Mr. Sternotte) will be assessed separately. Students will be expected to pass both parts in order to receive credit for the course.
| Training | Study programme | Block | Credits | Mandatory |
|---|---|---|---|---|
| Master in Pharmacy | Finalité approfondie | 1 | 2 | Yes |
| Master in Pharmacy | Finalité spécialisée | 1 | 2 | Yes |