Implications of inappropriate prescription of oral nutritional supplements on the quality of life of cancer outpatients: a cross-sectional comparative study

Hassanin, Islam A.; Salih, Reem F. M.; Fathy, Marwa; Hassanin, Eman A.; Selim, Dina H.

doi:10.1007/s00520-022-06837-6

Cited by 3 publications

(1 citation statement)

References 36 publications

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“…As quality of life is a central consideration in developing nutrition guidelines for cancer survivors 17 and older adults, 98 research is needed to determine the risks and benefits of prescribing ONS and their intake beyond physical effects on body weight and nutrition status and also on psychological health and social relationships. In cancer outpatients, prescribing ONS has not been shown to favorably impact quality of life, 99 whereas preliminary evidence suggests that plant‐based diets may improve cancer‐related fatigue 100 . Similarly, implementing individualized food and nutrition approaches can enhance the quality of life and nutrition status of older adults in a variety of settings, including relaxing food restrictions and emphasizing food preferences vs resorting to supplementation 32 .…”

Section: Potential Risks Of Ultraprocessed Onsmentioning

confidence: 99%

Recommending ultra‐processed oral nutrition supplements for unintentional weight loss: Are there risks?

et al. 2022

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Oral nutrition supplements (ONS) are widely recommended for the management of unintentional weight loss in patient populations, long-term care residents, and community-dwelling older adults. Most marketed ONS are ultra-processed, with precision nutrition and aseptic composition, as well as convenience and availability, driving their selection. However, therapeutic effectiveness is mixed and the potential health risks of consuming ultraprocessed ONS long-term in lieu of less-processed foods have received little attention. A diverse and balanced microbiota supporting immunity and wellness is maintained by a diet rich in plant-sourced foods. The implications of ultra-processed ONS displacing plant-sourced foods, and specifically the potential for undesirable impacts on the gut microbiota, require consideration.Most ONS are either devoid of fiber or are supplemented with isolated or purified fibers that may contribute to adverse gastrointestinal symptoms and appetite suppression. In contrast, the diversity of microbial-available, nondigestible carbohydrates, together with the array of phytochemicals found in plant-sourced foods, support microbial diversity and its resiliency. This review outlines the clinical dilemma of recommending commercial ultraprocessed ONS vs nutritionally adequate (eg, high-energy/high-protein) foods and beverages that contribute to diet quality, maintenance of a diverse and stable gut microbiota composition, and support nutrition status and health. Ultra-processed ONS may fall short of expected health benefits, and overreliance may potentially contribute to the risk for patient and older adult populations because of the displacement of a variety of healthful foods.

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Section: Potential Risks Of Ultraprocessed Onsmentioning

confidence: 99%

Recommending ultra‐processed oral nutrition supplements for unintentional weight loss: Are there risks?

et al. 2022

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How quality of life is measured in studies of nutritional intervention: a systematic review

Pemau,

González-Palacios,

Kerr

2024

Health Qual Life Outcomes

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Background Nutrition care can positively affect multiple aspects of patient’s health; outcomes are commonly evaluated on the basis of their impact on a patient’s (i) illness-specific conditions and (ii) health-related quality of life (HRQoL). Our systematic review examined how HRQoL was measured in studies of nutritional interventions. To help future researchers select appropriate Quality of Life Questionnaires (QoLQ), we identified commonly-used instruments and their uses across populations in different regions, of different ages, and with different diseases. Methods We searched EMCare, EMBASE, and Medline databases for studies that had HRQoL and nutrition intervention terms in the title, the abstract, or the MeSH term classifications “quality of life” and any of “nutrition therapy”, “diet therapy”, or “dietary supplements” and identified 1,113 studies for possible inclusion.We then reviewed titles, abstracts, and full texts to identify studies for final inclusion. Results Our review of titles, abstracts, and full texts resulted in the inclusion of 116 relevant studies in our final analysis. Our review identified 14 general and 25 disease-specific QoLQ. The most-used general QoLQ were the Short-Form 36-Item Health Survey (SF-36) in 27 studies and EuroQol 5-Dimension, (EQ-5D) in 26 studies. The European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC-QLQ), a cancer-specific QoLQ, was the most frequently used disease-specific QoLQ (28 studies). Disease-specific QoLQ were also identified for nutrition-related diseases such as diabetes, obesity, and dysphagia. Sixteen studies used multiple QoLQ, of which eight studies included both general and disease-specific measures of HRQoL. The most studied diseases were cancer (36 studies) and malnutrition (24 studies). There were few studies focused on specific age-group populations, with only 38 studies (33%) focused on adults 65 years and older and only 4 studies focused on pediatric patients. Regional variation in QoLQ use was observed, with EQ-5D used more frequently in Europe and SF-36 more commonly used in North America. Conclusions Use of QoLQ to measure HRQoL is well established in the literature; both general and disease-specific instruments are now available for use. We advise further studies to examine potential benefits of using both general and disease-specific QoLQ to better understand the impact of nutritional interventions on HRQoL.

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Pharmacists’ Perceptions on Nutritional Counseling of Oral Nutritional Supplements in the Community Pharmacy: An Exploratory Qualitative Study

2023

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Malnutrition has important health impacts, especially in the elderly. Oral nutritional supplements (ONS) are effective strategies to help balance the nutritional needs of malnourished persons. Multiple ONS are available at community pharmacies, enabling pharmacists to have the possibility to implement strategies for prevention and monitoring of malnourished patients. The aim of this study was to characterize the experience of community pharmacists with the counseling and follow-up of users of ONS. A sample of 19 pharmacists from 19 different community pharmacies were interviewed. Apart from dispensing ONS to support patients that are preparing for diagnostic tests, the most frequently mentioned clinical condition for ONS counseling was malnutrition and dysphagia. When pharmacists consider dispensing ONS, three themes emerge: patient care, related to counselling tailored ONS to each patient’s needs; interprofessional collaboration, with a special focus in the collaboration with registered dietitians; and training and education on ONS, looking to improve their knowledge and skills in ONS counselling and follow-up. Future studies exploring new forms of interaction between pharmacists and dietitians in this context should be developed, aiming to determine the workflow of an interdisciplinary service addressing the needs of community dwelling malnourished patients.

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Implications of inappropriate prescription of oral nutritional supplements on the quality of life of cancer outpatients: a cross-sectional comparative study

Cited by 3 publications

References 36 publications

Recommending ultra‐processed oral nutrition supplements for unintentional weight loss: Are there risks?

Recommending ultra‐processed oral nutrition supplements for unintentional weight loss: Are there risks?

How quality of life is measured in studies of nutritional intervention: a systematic review

Pharmacists’ Perceptions on Nutritional Counseling of Oral Nutritional Supplements in the Community Pharmacy: An Exploratory Qualitative Study

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