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The peripherally inserted central catheter (PICC) has been widely used for various indications, such as delivering chemotherapy drugs and parenteral nutrition support (Al Hadidi, 2018;Chopra et al., 2017).PICC is cost-effective and could facilitate the management of patients and improve their quality of life (Campagna et al., 2019;Xie et al., 2017). Nonetheless, PICC could cause a series of complications including peripherally inserted central catheter-related thrombosis (PICC-RT), catheter-related bloodstream infection and medical adhesive-related skin injury (Scrivens et al., 2020). Of these, PICC-RT is the most detrimental complication which could result in pulmonary embolism and even death (Hua et al., 2019). PICC-RT could also interrupt the intravenous treatment and increase the cost of care, bringing huge psychological burdens to the patients and economic burdens to the society (Burns & McLaren, 2009). Thus, early detection and prevention of PICC-RT have clinical and societal significance.

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BackgroundOral nutritional supplements (ONS) is a cost-effective nutritional therapy in patients with gastrointestinal cancer. However, information is lacking about adherence to ONS in general clinical settings. Figuring out adherence to ONS and related factors will provide evidence for the improvement of ONS usage practice.ObjectiveThe aim of this study was to survey adherence to ONS in gastrointestinal cancer patients with an ONS prescription and the factors associated with it.MethodsA mixed-method prospective study was conducted. Multivariate analysis and semistructured interviews were performed to identify factors that affected patient adherence to ONS.ResultsOf 111 gastrointestinal cancer patients provided with an ONS prescription, the median of adherence to ONS was 50.00% (interquartile range, 28.57%–91.67%). Multivariate analysis indicated that participants with low weight showed higher adherence to ONS than those with normal weight (β = −2.61, P = .011) or overweight (β = −3.25, P = .002). Semistructured interviews on 14 participants suggested that factors related to adherence to ONS were needs perception and benefits, clarity of the target daily ONS intake, tolerance to ONS, the impact of disease or treatment, personal preference, and professional support.ConclusionThis study reveals poor adherence to ONS in patients with gastrointestinal cancer and factors related to it in current clinical settings.Implications for PracticeOur findings could provide evidence for the development of strategies to improve ONS usage practice. It suggests that the practice in ONS should be improved from aspects of nutritional assessment, education, tolerance, and symptom management, as well as follow-up and monitoring of patients.