Nutritional management of cystic fibrosis in Australia and New Zealand

Abstract

Aim: To document current practice in the nutritional management of cystic fibrosis in Australia and New Zealand and to examine changes in practice since 1996. Methods: Thirty‐four cystic fibrosis services in Australia and New Zealand responded to a survey that examined current nutritional management practices and dietetic staffing levels. The questionnaire was based on a previous survey conducted in 1996. Results: Cystic fibrosis dietetic staffing levels were low. No service met the staffing level recommended by the UK Cystic Fibrosis Trust. Minor practice variations existed in nutrition assessment and monitoring: nutrition support and vitamin supplementation. Changes in the management of pancreatic enzyme replacement therapy and cystic fibrosis‐related diabetes were reported since 1996. Conclusion: This survey highlights that improvements in consistency of nutrition management have been achieved since 1996 and reflect adherence to available clinical guidelines for pancreatic enzyme replacement therapy. While there are many areas of agreement in nutrition care for people with cystic fibrosis around Australia and New Zealand, there are still practice differences, implying that Australian‐ and New Zealand‐specific clinical guidelines are warranted. The implementation of the Australasian Clinical Practice Guidelines for Nutrition in Cystic Fibrosis will be important in standardising and improving cystic fibrosis care.

Nutritional management of cystic fibrosis and cystic fibrosis‐related diabetes in Australia

“…It is promising that a number of dietitians reported nutritional management strategies consistent with the recently published Australian Standards of Care for Cystic Fibrosis‐Related Diabetes . Dietary management of CFRD reported in this survey is considerably different from that reported in early surveys of Australian dietitians treating patients with CF . In a 1996 survey, the majority of dietitians did not report providing dietary advice for the management of CFRD to their patients, and a number of those who did reported recommending restriction of carbohydrate .…”

“…In a 1996 survey, the majority of dietitians did not report providing dietary advice for the management of CFRD to their patients, and a number of those who did reported recommending restriction of carbohydrate . A second survey published in 2008 reported dietitians were individualising dietary advice for those with CFRD taking into account a patient's medical and nutritional status . Low glycaemic index dietary choices were also commonly reported .…”

“…In Australia, CF care is typically provided by a multidisciplinary team within large tertiary hospitals; however, some services are provided by smaller regional units . Treatment at specialised tertiary hospitals provided by experienced clinicians allows services to deliver quality care.…”

“…Following best practice guidelines ensures that patients with CF receive evidence‐based and consistent nutritional management from dietitians. Currently, there is a lack of data on the consistency of dietetic management between Australian CF centres, with little to no information on whether dietetic services are being delivered in accordance with national evidence‐based guidelines . The most recent surveys of Australian dietetic practice in CF were last undertaken in 1996 and 2005, and included only minimal information on the management of CFRD.…”

“…Currently, there is a lack of data on the consistency of dietetic management between Australian CF centres, with little to no information on whether dietetic services are being delivered in accordance with national evidence‐based guidelines . The most recent surveys of Australian dietetic practice in CF were last undertaken in 1996 and 2005, and included only minimal information on the management of CFRD. This research sought to provide a snapshot of current dietetic practices in the management of CF in Australia, with a specific focus on the management of CFRD.…”