Cancer malnutrition is common and is associated with reduced tolerance of treatment and quality of life, increased complications, extended length of stay and higher health care costs. This project aimed to determine current screening and dietetic practices within CDU and to monitor the impact of a proactive dietetic screening, assessment and nutrition counselling model of care.
For each patient, data was collected at week 1 and week 6+2 weeks during the Baseline and Pilot data collection periods. Outcomes measured included malnutrition risk (Malnutrition Screening Tool – MST) and diagnosis of malnutrition (Patient Generated-Subjective Global Assessment - PG-SGA), unplanned admissions, length of stay and quality of life amongst new ambulatory CDU patients.
The new model of care resulted in 94% of new patients screened for malnutrition, of which 68% received timely dietetic intervention. Results included statistically significant improvements in weight change (+1.3kg, p=0.011), Body Mass Index (BMI) (p=0.009) and significantly fewer patients at risk of malnutrition (35.1% in baseline versus 11.7% in pilot model, p=0.027) at week 6 of treatment. The overall trend in PG-SGA score was less for the pilot model group (4.5 points lower at Week 6) indicating an improvement in nutritional status at week 6. The global PG-SGA rating improved from Week 1 to Week 6, with fewer patients rating SGA B (moderately malnourished) or C (severely malnourished). There was a trend towards reduced LOS from 4 days to 2 days in patients admitted from the baseline patient sample compared to pilot model.
The new model of care ensured CDU patients were screened for malnutrition risk and received timely dietetic intervention.