A multidisciplinary team approach for nutritional interventions conducted by specialist nurses in patients with advanced colorectal cancer undergoing chemotherapy

Abstract

Background & aims:Nutritional interventions for malnutrition in cancer patients can be helpful. However, concise intervention recommendations remain controversial. Thus, the aim of this study was to report on a nutrition intervention conducted by a multidisciplinary team of specialist nurses and to explore the effect of nutritional intervention on cancer patients.Methods:This prospective clinical trial study enrolled 110 colorectal cancer patients undergoing chemotherapy. The patients were evaluated upon admission using the 2002 Nutritional Risk Screening system (NRS-2002). The patients were randomly divided into intervention and control groups including 55 patients each. Patients in the control group were administered a normal diet, while those in the intervention group received individual recipes developed by a team of professional nurses, clinical doctors, dietitian, family caregivers, and the patients themselves. Patient weight and serum albumin and prealbumin levels were compared between the 2 groups at different time points.Results:There was a significant difference in patient weight and serum albumin and prealbumin levels before and after nutrition intervention in the intervention group (P < .05). In the control group, weight did not change during ordinary diet guidance. Serum albumin level was slightly improved after 12 cycles of chemotherapy, similar to the prealbumin results. There were statistically significant differences in serum albumin and prealbumin levels between the intervention and control groups after nutrition intervention (P < .05). However, there was no statistically significant difference in weight between the groups after nutrition intervention (P > .05).Conclusion:A multidisciplinary team approach for nutrition intervention conducted by specialist nurses improved prealbumin levels in colorectal cancer patients undergoing chemotherapy, with no weight change.

Barriers in Nursing Practice in Cancer Cachexia: A Scoping Review

“…One psychosocial, two nutritional, and one physical activity interventions were included for review. [ 28 29 30 31 ] The comparability of study outcomes was limited because the study populations (cancer type or stage), objectives, and outcome measures were inconsistent among these studies.…”

Health services research in colorectal cancer: a quasi-experimental interventional pilot study on in- and outpatient oncology

“…The RCT from Ravasco et al (2012) also showed that intensive nutritional counseling of colorectal cancer patients is the most effective means of improving nutritional status during radiotherapy. Lin et al (2017) and Dobrila-Dintinjana et al (2013) also demonstrated that individual nutritional counseling and administration of dietary supplements reduced weight loss and improved appetite in colorectal cancer patients, thus stabilizing nutritional status and reducing chemotherapyinduced morbidity. In the current study, the intensity of nutritional counseling depended on the frequency of GI side effects, which were most frequent in the intervention group with the use of inand outpatient counseling.…”

“…Due to the large catchment area of the hospital, consultations were occasionally carried out by telephone. The following areas were addressed: the selection of suitable foods and drinks with concrete portion sizes; methods of food preparation; distribution of total quantities over smaller more frequent meals; enrichment of meals with sources of energy and protein; and oral nutritional supplementation (Lin et al 2017 ). Between counseling sessions, patients kept a food and bowel diary, which was used to adapt the specific nutritional recommendations after each session depending on side effects and body weight (Arends et al 2017 ).…”

Empowering patient education on self-care activity among patients with colorectal cancer – a research protocol for a randomised trial

“…Only few studies have explored the effect of nurse-led nutritional interventions among this patient group, yet the results have been promising. A multidisciplinary team approach for nutritional interventions (individual recipes, nutritional risk screening, total energy requirement calculation, education and diet adjustments) conducted by specialist nurses has obtained a positive effect on pre-albumin levels among CRC patients undergoing chemotherapy [21]. An individualised educational program with face-to-face and telephone counselling gained positive results on energy and total protein intake among patients with CRC (n = 19 + 21) in palliative care context [22].…”