Dietary Counselling Using Nutrition Care Process Pathway in Cancer Patients Receiving Chemotherapy and/or Radiotherapy Improves Nutritional Status, Quality of Life and Patient Experience Compared with Standard Practice - A Randomized Controlled Single Cen
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To determine the impact of Intensive Dietary Counselling (IDC) using Nutrition Care Process (NCP) pathway compared with standard practice (general nutrition advice of foods taken ad libitum) on nutritional status and Quality of Life (QoL) in patients receiving chemotherapy and/or radiotherapy. The patient satisfaction with the IDC model was assessed. This prospective, randomized, controlled trial included 150 adult patients undergoing chemotherapy and/or radiation therapy at Cytecare Cancer Hospitals, Bengaluru. Patients were randomized to receive either dietary counselling using NCP pathway (n=80) or standard practice (n=70). Outcome measures were QoL assessed using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 and nutritional status was assessed using Subjective Global Assessment at baseline and after 12 weeks of starting treatment. Patient experience was recorded using organizational patient satisfaction survey tool. The dietary counselling group showed improved QoL compared with the standard practice group at the end of 12 weeks of starting treatment (p<0.01). The body weight and nutritional status significantly improved in the group that received dietary counselling using the NCP pathway compared with standard practice (p<0.01). The dietary counselling group also reported higher patient satisfaction with the nutrition intervention compared with standard practice. Dietary counselling following the nutrition care process pathway result in significant difference in the QoL and nutritional status compared with standard practice in patients undergoing cancer treatment. Nutrition intervention using this model also increased the patient experience.
Keywords
- Gangadharan, A., Choi, S.E., Hassan, A., Ayoub, N.M., et al. Protein calorie malnutrition, nutritional intervention and personalized cancer care. Oncotarget., 2017, 8, 24009-24030.
- Ravasco, P., Monteiro-Grillo, I., Marques, V.P., et al. Impact of nutrition on outcome: a prospective randomized controlled trial in patients with head and neck cancer undergoing radiotherapy. Head Neck, 2005, 27, 659-668.
- Newman, L.A., Vieira, F., Schwiezer, V., et al. Eating and weight changes following chemoradiation therapy for advanced head and neck cancer. Arch. Otolaryngol. Head Neck. Surg., 1998, 124, 589-592.
- van den Berg, M.G., Rasmussen-Conrad, E.L., Wei, K.H. and Lintz-Luidens, H. Comparison of the effect of individual dietary counselling and of standard nutritional care on weight loss in patients with head and neck cancer undergoing radiotherapy. Brit. J. Nutr., 2010, 104, 872-877.
- Dewys, W.D., Begg, C., Lavin, P.T., et al. Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am. J. Med., 1980, 69, 491-497.
- Reily Jr. J.J., Hull, S.F., Albert, N., Waller, A. and Bringardener, S. Economic impact of malnutrition: a model system for hospitalized patients. J. Paren. Enter. Nutr., 1988, 12, 371-376.
- Ravasco, P., Grillo, I.M. and Camilo, M. Cancer wasting and quality of life react to early individualized nutritional counselling! Clin. Nutr., 2007, 26, 7-15.
- Langius, J.A.E., Zandbergen, M.C., Eerenstein, S.E.J., et al. Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo) radiotherapy: a systematic review. Clin. Nutr., 2013, 32, 671-678.
- Bicakli, D.H., Akagunduz, O.O., Dalak, R.M., Esassolak, M., Uslu, R. and Uyar, M. The effects of compliance with nutritional counselling on body composition parameters in head and neck cancer patients under radiotherapy. J. Nutr. Metb., 2017, 2017, 1-7. Doi: 10.1155/2017/8631945.
- Isenring, E.A., Bauer, J.D. and Capra, S. Nutrition support using the American Dietetic Association medical nutrition therapy protocol for radiation oncology patients improves dietary intake compared with standard practice. J. Am. Diet. Assoc., 2007, 107, 404-412.
- Grant, B.L. Pocket Guide to the Nutrition Care Process and Cancer. Academy of Nutrition and Dietetics, 2015, 1-13.
- Langius, J.A.E., Doornaert, P., Spreeuwenberg, M.D., Langendijk, J.A., Leemans, C.R. and Schueren, M.A. Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer. Radiothe. Oncol., 2010, 97, 80-85.
- Garg, S., Yoo, J. and Winquist, E. Nutritional support for head and neck cancer patients receiving radiotherapy: a systematic review. Supportive Care in Cancer, 2010, 18, 667-677.
- Waele, E.D., Mattens, S., Honoré, P., Spapen, H., Grève, J.D. And Pen, J.J. Nutrition therapy in cachectic cancer patients. The Tight Caloric Control (TiCaCo) pilot trial. Appet., 2015, 91, 298301.
- Langius, J.A.E., Zandbergen, M.C. and Eerenstein, S.E.J. Effect of nutritional interventions on nutritional status, quality of life and mortality in patients with head and neck cancer receiving (chemo) radiotherapy: a systematic review. Clin. Nutr., 2013, 32, 671-678.
- Uster, A., Ruefenacht, U., Ruehlin, M., Pless, M., Siano, M., Haefner, M., et al. Influence of a nutritional intervention on dietary intake and quality of life in cancer patients. A randomized controlled trial. Nutr., 2013, 29,1342-1349.
- Neelemaat, F., Bosmans, J.E., Thijs, A., et al. Oral nutritional support in malnourished elderly decreases functional limitations with no extra costs. Clin. Nutr., 2012, 31, 183-190.
- Norman, K., Pirlich, M., Smoliner, C., et al. Cost-effectiveness of a 3-month intervention with oral nutritional supplements in disease-related malnutrition: a randomised controlled pilot study. Eur. J. Clin. Nutr., 2011, 65, 735-742.
- Centers for Medicare and Medicaid Services. What are the value-based programs? www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs.html.
- Sulo, S., Feldstein, J., Partridge, J., Schwander, B., Sriram, K. and Summerfelt, W.T. Budget impact of a comprehensive nutrition-focused quality improvement program for malnourished hospitalized patients. Am. Health Drug Benefits., 2017, 10, 262-270.
- Macleod, M., Steele, R.J.C., O'Carroll, R.E., Wells, M., Anna Campbell, A., et al. Feasibility study to assess the delivery of a lifestyle intervention (TreatWELL) for patients with colorectal cancer undergoing potentially curative treatment. BMJ Open., 2018, 8, e021117.
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