Author of

• 11001

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  P1.24 - Poster Session 1 - Clinical Care (ID 146)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11051

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    P1.24-050 - Pilot of a weekly dietetic telephone clinic for thoracic oncology outpatients: a UK cancer centre experience. (ID 3251)

    09:30 - 09:30  |  Author(s): G. Howell
    • Abstract

    Background
    Nutritional decline and weight loss are common features in thoracic oncology patients and are independent prognostic indicators for survival in lung cancer. Malnutrition reduces tolerability to treatment and increases both risk of complications and unplanned hospitalisation, all of which lead to increased disability and reduced quality of life (Ravasco et al, 2004). Changes in eating habits and weight loss can also cause significant psychological distress to both patients and carers. Nutritional assessment and support should therefore be an integral component of the lung cancer patient’s care. The UK National Institute for Clinical Excellence recommends that all outpatients are screened for malnutrition at their first visit. We previously reported on a three month nutritional audit which identified that 37% of patients were at risk of malnutrition, confirming the need for dietary intervention (Howell, 2013). Subsequently an online referral system and a weekly dietetic telephone clinic were established to offer interim support to all outpatients. Data is presented here on the first 7 months of our year-long pilot project.

    Methods
    Between November 2012 and May 2013 all patients presenting to the Papworth Thoracic Oncology Service (PATHOS) with suspected thoracic malignancy were screened for malnutrition using the Malnutrition Universal Screening Tool (MUST) as part of a Holistic Needs Assessment. Patients at high risk of malnutrition (i.e. MUST score ≥2) received written and verbal advice on first line nutritional support, were commenced on oral dietary supplements and referred to the dietetic telephone clinic.

    Results
    26 patients were referred to the dietetic telephone clinic. Assessment calls took approximately 30 minutes, whilst follow-up calls took 10-15 minutes. All patients received an initial assessment call, and the majority of patients received at least one additional follow-up call. 13 (50%) patients were subsequently referred to a community dietician for further management. The following comments are examples of the feedback received. Patient A “it was helpful to have confirmation of what I should be eating and the types of foods to focus on”. Patient B “the information I received on food consistency and the different products available really helped”.

    Conclusion
    A multi-disciplinary team approach has been established to support and educate thoracic oncology outpatients about their nutritional requirements. Although the numbers are small, the new service has been well received by both patients and staff. The online referral system is easy to use and the written information leaflet contains details of the referral and when patients will be contacted. Developments: Modify the online referral system to include likely diagnosis and future plans. Maintain continuous audit, also collect data on: Diagnosis and stage of disease Eventual treatment plan Outcome of community referral Introduce an anonymous patient satisfaction questionnaire. Consider using a nutritional screening tool specific to oncology patients. References: Ravasco P. Monteiro-Grillo I. Marques Vidal P. & Camilo ME. (2004) Cancer: disease and nutrition are key determinants of patient's quality of life. Supportive Care in Cancer. 12: 246-252 Howell G. (2013) Nutritional reassessment and dietary support of thoracic oncology patients is a "MUST". Lung Cancer. 79 (suppl 1): S42