OBJECTIVES: Oral nutrition supplements (ONS) improve real world outcomes in the hospital setting, but data from longer-term or community-setting use are lacking.  We examined baseline characteristics of patients who had initiation of ONS documented in electronic medical records for comparison with a non-ONS user control group. METHODS: We retrospectively analyzed electronic health records from 1,251 patients ≥18 years old from Geisinger Health System who had at least 2 ONS orders in outpatient or inpatient settings, excluding tube feeding, between 2009 and 2014.  For comparison purposes, 25,513 patients with no ONS orders were examined as a control group.  Index date was defined as the first ONS order, or for the controls, a randomly-selected clinical encounter within the time period.  Final cohorts were restricted to patients with a Charlson Comorbidity Index (CCI) of >2 and who had been hospitalized in the 12 months prior to index.  Multivariate logistic regression (propensity) modeling was used to describe and compare differences in baseline characteristics between the groups including age, sex, race, tobacco use, and comorbidities. RESULTS: ONS users were mostly female (54%) and Caucasian (98%).  Current smoking was uncommon (14%), but 42% had previously smoked tobacco.  In comparison to non-ONS users, the ONS group was significantly older (mean of 72 vs. 63 years, p<0.001). ONS patients had a significantly higher mean Charlson Comorbidity Index (6.9 vs. 4.7, p<0.001) at ONS initiation, with the most common comorbidities being chronic obstructive pulmonary disease (55%), type 2 diabetes (45%), renal disease (45%), congestive heart failure (42%), and cancer (40%). CONCLUSIONS: Patients with ONS orders are older and clearly have higher morbidity than non-ONS users. Propensity score distributions of the ONS and non-ONS users are different but overlap, suggesting that a propensity score matching approach to a future comparative analysis of outcomes appears feasible.