Nutrition care is an integral part of patient-centred medical care: a European consensus

Illuminating the nutrition-related policy-practice gaps in colorectal cancer survivorship

PURPOSE

Colorectal cancer (CRC) is among the three most commonly diagnosed cancers globally, after breast and lung cancer, with an estimated 2 million new cases each year, comprising ten per cent of all cancers worldwide. CRC has a complex aetiology associated with several nutrition-related risk factors. Cancer survivors frequently report alterations to their dietary habits and nutritional intake, with related adverse impacts on health-related quality of life (QOL). Whilst nutrition-related factors are recognised as survivor priorities and embedded in survivor care policies, dietary support is frequently not the standard of care in practice.

METHODS AND RESULTS

In this Commentary, we present details of a critical policy-practice gap for CRC survivors across the spectrum of nutrition care that we have seen growing in the literature, in hospitals, community and private practice.

CONCLUSION

As these nutrition concerns can adversely impact QOL and morbidity and mortality risks, we hope to raise awareness of these issues to provide a basis of future work in this area, so that policymakers and clinicians can improve support and outcomes for CRC survivors and their families.

Management of cancer cachexia towards optimizing care delivery and patient outcomes

Cancer cachexia is a complex syndrome characterized by progressive weight loss, muscle mass depletion, and systemic inflammation, profoundly affecting the well-being and treatment outcomes of cancer patients. Effective management of cancer cachexia demands a coordinated, multifaceted approach involving various healthcare disciplines and operational strategies. Streamlining care processes is crucial to ensure timely interventions and support, reducing delays in diagnosis and treatment initiation. Multidisciplinary collaboration is pivotal in creating integrated care plans that address the multifactorial nature of cancer cachexia comprehensively. Data-driven decision-making empowers healthcare teams to identify trends, monitor treatment responses, and tailor care plans to individual needs, ultimately leading to improved patient outcomes. Standardized assessment and monitoring play a vital role in maintaining consistent, high-quality care, facilitating early interventions and treatment adjustments. Implementing patient-centered care fosters trust, enhances treatment adherence, and encourages patients to actively engage in their care journey, thereby improving their overall quality of life. This paper underscores the significance of applying operations management principles to optimize care delivery and enhance patient outcomes in the management of cancer cachexia. It provides valuable insights for healthcare institutions and professionals striving to provide comprehensive and effective care for individuals affected by this challenging condition.

Closing the cancer care gap with a patient-reported nutrition screening: A retrospective analysis of a quality improvement project on an oncology ward (CCC study)

BACKGROUND & AIMS

Early identification of patients at risk for malnutrition followed by individualized nutrition interventions is a central step to the provision of appropriate nutrition care. However, a health care professional (HCP)-based nutrition screening is not always consistently integrated into routine care. Patient-reported (PR) nutrition screening could thus potentially alleviate the burden on the HCPs and contribute to a greater number of patients who are identified and treated for malnutrition.

METHODS

In 2021 a Quality Improvement Project (QIP) at our out-patient oncology clinic was undertaken to implement the change from a HCP-based nutrition screening to a PR-screening. This was followed by a retrospective analysis in which the primary outcome measure was the rate of nutrition consultations initiated for patients undergoing cancer therapy.

RESULTS

In total n = 1657 patient data sets derived from comparable time periods before and after the QIP were analyzed and compared. Both groups had a comparable mean age and gender distribution. The most common diagnosis in both groups was gastrointestinal tumors. The change in routine care from a HCP-based nutrition screening to a PR-screening led to a significant increase in nutrition consultation rates (RD = 19%; p < 0.001; 95% CI 14.4%-23.5%) and screening rates (RD = 30.5%; p < 0.001; 95% CI 26.2%-34.7%).

CONCLUSIONS

The change to PR-screening potentially facilitates an increase in nutrition screening rates. This in turn leads to an increased rate of patients identified at risk for malnutrition and thus referrals for nutrition consultations. Our findings indicate that a PR nutrition screening tool could play a role in closing the care gap and contribute to reducing rates of malnutrition among this population where screening is not consistently integrated into routine care.