An evaluation of malnutrition screening, dietitian intervention and patient knowledge of nutrition support available within an Australian oncology outpatient setting

Abstract

Malnutrition is common among oncology patients and may negatively affect treatment outcomes. Dietitians can assist patients with maintaining adequate nutritional intake, minimising weight loss and preventing malnutrition, often exacerbated by nutrition impact symptoms (NIS) frequently experienced by those receiving chemotherapy. The study aimed to assess whether oncology outpatients at risk of malnutrition were appropriately referred to a dietitian. An observational crosssectional study was completed with patients receiving outpatient chemotherapy (n = 40). Patients were screened for malnutrition risk using a validated screening tool (Malnutrition Screening Tool [MST]) with the score compared against the initial MST score (completed at the commencement of treatment by nursing staff). A questionnaire evaluated patient perception of weight change, dietary changes and NIS experienced. Initial malnutrition screening identified 22.5% (n = 9) patients at nutritional risk (MST ≥ 2). The MST repeated during the study identified nine patients as at risk of malnutrition after commencing treatment that had not been referred to the dietitian for nutritional assessment and support. Two-thirds of patients experienced weight changes, of which 78% were unconcerned. All patients reported experiencing at least one NIS and were most likely to seek advice from their Oncologist for management. The study confirmed that malnutrition screening should be completed throughout cancer treatment to enable appropriate dietetic referral of patients at risk of malnutrition. Patients undergoing chemotherapy may benefit from early education to ensure they are able to identify negative outcomes from unintentional weight changes and monitor for NIS and consequently self-refer for dietetic input as required.