Eating As Treatment (EAT): A Stepped-Wedge, Randomized Controlled Trial of a Health Behavior Change Intervention Provided by Dietitians to Improve Nutrition in Patients With Head and Neck Cancer Undergoing Radiation Therapy (TROG 12.03)

Nutrition Status and Health‐Related Quality of Life Among Outpatients With Advanced Head and Neck Cancer

“…Thus, it is debatable whether the association between nutrition status and HRQOL was mediated by the severity of disease and/or treatment modality rather than suggesting a causal relationship between nutrition and QOL outcomes. Nonetheless, patients have benefited from regular nutrition counseling provided by an RD during various phases of cancer treatment 32,34‐36 . This is supported by a recent trial in which HNC patients receiving RD counseling showed improvements in nutrition status (indicated by lower PG‐SGA scores) and body weight, had fewer treatment interruptions, and reported higher HRQOL as measured by EORTC 34 …”

“…Nonetheless, patients have benefited from regular nutrition counseling provided by an RD during various phases of cancer treatment. 32,[34][35][36] This is supported by a recent trial in which HNC patients receiving RD counseling showed improvements in nutrition status (indicated by lower PG-SGA scores) and body weight, had fewer treatment interruptions, and reported higher HRQOL as measured by EORTC. 34…”

Translating Evidence-Based Guidelines into Practice—Are We Getting It Right? A Multi-Centre Prospective International Audit of Nutrition Care in Patients with Foregut Tumors (INFORM)

“…The remainder of the adherence criteria are reported as a proportion of included patients and by participating site. The optimum degree of adherence to EBGs has not been determined; however, adherence rates of 80% to set criteria has been proposed [ 14 ] and applied in recent studies [ 37 , 38 ]. In this study, adherence to EBG recommendations was categorized as good (≥80%), moderate (≥60 to 80%) and poor (60%).…”

“…A Canadian-led international qualitative study exploring the barriers and enablers to nutrition care of patients with foregut tumors identified, firstly, a need to improve the evidence base and, secondly, to establish a minimum data set with a view to developing standardized nutrition care pathways with defined roles and responsibilities [ 36 ]. Recent Australian-led studies demonstrated that the multi-strategic implementation of innovative models of care increased adherence to EBGs for nutritional management of patients with HNC [ 8 ] resulted in improvements in nutritional status, quality of life [ 37 ], treatment completion, unplanned hospital admissions and associated costs of care [ 38 ]. This study aimed to (i) describe and evaluate current international nutrition care practices compared with the best-available evidence from published EBGs for patients with foregut tumors at high risk of malnutrition and (ii) determine any critical points where evidence–practice gaps persist and identify opportunities for improvement in nutrition care processes.…”

Nutrition and swallowing therapy strategies for patients with head and neck cancer

“…Psychological techniques have been shown to improve nutritional behaviours in HNC patients undergoing treatment. The "Eating as Treatment" (EAT) trial used motivational interviewing and cognitive behavioral therapy delivered by oncology dietitians and integrated into their clinical practice to improve nutritional outcomes [55]. EAT was a stepped wedge controlled trial and demonstrated that HNC patients receiving the intervention had better nutritional status and were more likely to: be assessed as well-nourished at each time point; lose a smaller percentage of weight have fewer treatment interruptions; present lower depression scores; and report a higher quality of life compared to standard care [55].…”