Establishing the need for provider education on cancer and nutrition (PECAN): Survey results on nutrition practices at a large community oncology practice.

Authors

null

Karen Smith

Texas Oncology, Dallas, TX

Karen Smith, Lance Ortega, Lalan S. Wilfong, Sabrina Q. Mikan, John F. Sandbach, Kathryn Elizabeth Hudson

Organizations

Texas Oncology, Dallas, TX, Texas Oncology PA, Dallas, TX, Texas Oncology, The US Oncology Network, Dallas, TX, Texas Oncology, Austin, TX, Texas Oncology-Austin, Austin, TX, Duke University Medical Center, Durham, NC

Research Funding

No funding received
None

Background: Oncology providers and patients benefit from evidence-based nutritional resources to support cancer care. For patients, proper nutrition care can prevent inappropriate weight loss, improve treatment tolerance, and improve quality of life. Recent literature has noted the lack of both adequate dietitian resources at outpatient centers and comprehensive nutrition guidelines in cancer care. At a large community practice with 210 locations across Texas and Oklahoma, a survey was developed and administered to assess nutrition practices. Methods: Clinic directors in the practice completed a survey to assess for the presence or absence of a malnutrition screen; how nutrition concerns are addressed; and the availability of a dietitian. Results: A total of 26 responses detailed the nutrition processes at 50 unique locations. At 37 (74%) locations, a malnutrition screening tool was utilized and of these, 30 (81%) locations reported utilizing the Malnutrition Screening Tool (MST), a brief, validated tool for outpatient settings including oncology. Seven (19%) sites did not specify what tool was used. Of the clinics that reported completing a malnutrition screen for patients, the screen was completed by the advanced practice provider (APP)/physician in 18 (49%) clinics, a nurse in 4 (11%) clinics, a dietitian in 4 (11%) clinics and a medical assistant in 1 (3%) clinic. At 10 sites more than one provider type was responsible for completing the screen. Nutrition issues were addressed by physicians, APPs, and nurses in 15 (50%), 35 (70%), and 9 (14%) sites respectively (see table). Twenty-two locations (44%) reported referring patients to a dietitian and 10 sites (20%) had a dietitian available in clinic. Forty-one (82%) clinics employed more than one method for addressing nutrition issues. Sixteen of 26 respondents (62%) reported that increased dietitian access would be helpful; this included respondents whose locations already had a dietitian available. Conclusions: Overall, 74% of reporting locations used a malnutrition screening tool and 20% had access to a dietitian on site. Forty-four percent of sites referred to a dietitian if there was a need. This indicates that multiple providers are involved in the nutritional care of oncology patients. In response to these findings, the multidisciplinary PECAN Taskforce was created to develop comprehensive malnutrition screening, implement a referral process for all at-risk patients, enhance nutrition education, and expand dietitian services. Further study will measure the impact of expanded nutrition access on patient outcomes.

How are Nutrition Issues addressed in clinic
APP
35
Handouts
30
RD Referral
22
Physician
15
Nurse
9
Website
8

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Abstract Details

Meeting

2021 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cost, Value, and Policy; Health Equity and Disparities; Patient Experience

Track

Cost, Value, and Policy,Technology and Innovation in Quality of Care,Health Care Access, Equity, and Disparities,Patient Experience,Quality, Safety, and Implementation Science

Sub Track

Team-Based Approaches to Care Delivery

Citation

J Clin Oncol 39, 2021 (suppl 28; abstr 49)

DOI

10.1200/JCO.2020.39.28_suppl.49

Abstract #

49

Poster Bd #

Online Only

Abstract Disclosures

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