Malnutrition is prevalent in patients with head and neck cancer (HNC) at diagnosis but can occur at any stage of the treatment pathway. The impact of disease burden and treatment side effects can lead to altered anatomy, compromised quality and quantity of saliva and impaired swallowing function, which can result in deleterious effects on nutritional status. Optimising nutrition status is critical, as malnutrition is adversely associated with treatment tolerance and outcomes, wound healing, morbidity, mortality, quality of life and survival. Dietitians are integral members of the HNC multidisciplinary team and are uniquely qualified in the assessment, management and optimisation of nutritional status across the care pathway. This includes providing informational counselling to patients and carers on the short- and long-term nutritional impact of planned treatments alongside multidisciplinary members. Dietitians lead on the recommendation, provision and monitoring of nutrition support, which can be via the oral, enteral or parenteral route. Oral nutrition support includes dietary counselling, nourishing dietary, food fortification advice and high energy/protein oral nutritional supplements. Enteral nutrition support, or tube feeding, can be required on a short- and/or long-term basis and dietitians support appropriate decision-making for the type of tube and timing of placement across the care pathway.
BACKGROUND: Clinicals trials are the bedrock for evidence-based practice amongst healthcare professionals. Creating research opportunities through structured training is integral in developing future research leaders including allied health professionals (AHP)s. The UK National Institute for Health Research (NIHR) Associate Principal Investigator (API) scheme was launched in 2019 to support trainee medical, dental, nursing and AHPs to gain practical experience delivering clinical trials under local PIs. API certification requires completion of activities which includes Good Clinical Practice Training, attendance at trial meetings, trial recruitment and maintenance of site file related activities. The aim of this article was to showcase how the activities completed by an AHP undertaking the API scheme support researcher development. METHODS: SIP SMART2 is a multicentre trial of swallowing prehabilitation in head and neck cancer. SIP SMART2 was one of the first AHP-led trials to be registered on the API scheme in April 2019 with six APIs registered. The example of one trainee’s activities and skills acquisition by completing the scheme were compared to a well-established researcher development framework known as the Vitae Researcher Development Framework (RDF). RESULTS: Activities completed during the API scheme supported development across all 4 domains of the RDF. In particular, Domain C (Research governance and organisation) and Domain D (Engagement, influence and impact). CONCLUSIONS: The API scheme provides an opportunity for AHPs to gain skills and experience to develop across all domains of the Vitae RDF. Future work should assess whether completion of the API scheme leads to long-term engagement in clinical research.
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